{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T15:56:14Z","timestamp":1791042974152,"version":"4.1.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","funder":[{"name":"Department of Veterans Affairs, Specialty Care Program Office"},{"name":"Pain Management, Opioid Safety, and Prescription Drug Monitoring","award":["SP8FEP1P1"],"award-info":[{"award-number":["SP8FEP1P1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract\u2003<\/jats:title>\n                  <jats:p>Tertiary interdisciplinary pain rehabilitation programs (IPRPs) provide integrated, comprehensive pain rehabilitation using an evidence-based biopsychosocial approach delivered by teams offering multi-modal care. A 2009 Veterans Health Administration (VHA) Directive mandated implementation of Commission on Accreditation for Rehabilitation Facilities (CARF) accredited IPRPs in each Department of Veterans Affairs (VA) service network. Commission on Accreditation for Rehabilitation Facilities accreditation included regular program surveys to reinforce continuous quality and improvement standards. IPRPs are integral to the VHA\u2019s capacity to provide a stepped-care model including advanced pain diagnostics and functional rehabilitation to best meet the needs of veterans with complex chronic pain. Recently, VHA ended its enterprise-wide contract with CARF International for accreditation across all programs. The absence of a formal external accreditation process created a gap in sustaining quality oversight and may put VA IPRPs at risk for closure or losing their relevance as tertiary pain care centers. As such, the VA national Pain Management, Opioid Safety, and Prescription Drug Monitoring Program (PMOP) is launching an initiative to ensure governance, sustainability, and alignment with VHA and PMOP strategic priorities. PMOP\u2019s provision of oversight, support, and strategic direction is critical as the VA continues to sustain the highest quality standard for pain management and rehabilitation in the post-CARF era. This commentary will discuss current PMOP initiatives for VA IPRPs to address gaps left by the absence of the CARF accreditation framework.<\/jats:p>","DOI":"10.1093\/milmed\/usag443","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:34:47Z","timestamp":1789673687000},"source":"Crossref","is-referenced-by-count":0,"title":["Veterans Health Administration Pain Management Quality Improvement in a Post-Commission on Accreditation for Rehabilitation Facilities Era"],"prefix":"10.1093","author":[{"given":"Jolie N","family":"Haun","sequence":"first","affiliation":[{"name":"Research Service, James A. Haley Veterans\u2019 Hospital , Tampa, FL 33612,","place":["United States"]},{"name":"Division of Epidemiology, Department of Internal Medicine, University of Utah , Salt Lake City, UT 84112,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4460-8929","authenticated-orcid":false,"given":"Christopher","family":"Fowler","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Health Services Research and Development Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital , Hines, IL 60141,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2454-3109","authenticated-orcid":false,"given":"Rebecca S","family":"Bolinski","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Health Services Research and Development Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital , Hines, IL 60141,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0470-8869","authenticated-orcid":false,"given":"Jacquelyn N","family":"Heuer","sequence":"additional","affiliation":[{"name":"Informatics, Decision-Enhancement, and Analytics Sciences Center, VA Salt Lake City Health Care System , Salt Lake City, UT 84108,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Echevarria-Baez","sequence":"additional","affiliation":[{"name":"Opioid Safety, and Prescription Drug Monitoring Program, Specialty Care Program Office, Department of Veterans Affairs Central Office, National Pain Management , Washington, DC 20002,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedhelm","family":"Sandbrink","sequence":"additional","affiliation":[{"name":"Opioid Safety, and Prescription Drug Monitoring Program, Specialty Care Program Office, Department of Veterans Affairs Central Office, National Pain Management , Washington, DC 20002,","place":["United States"]},{"name":"Department of Neurology, Pain Management Program, Washington VA Medical Center , Washington, DC 20422,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,3]]},"reference":[{"key":"2026100311323645200_usag443-B1","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.15585\/mmwr.mm6736a2","article-title":"Prevalence of chronic pain and high-impact chronic pain among adults\u2014United States, 2016","volume":"67","author":"Dahlhamer","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026100311323645200_usag443-B2","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/j.jpain.2016.10.021","article-title":"Severe pain in veterans: the effect of age and sex, and comparisons with the general population","volume":"18","author":"Nahin","year":"2017","journal-title":"J Pain"},{"key":"2026100311323645200_usag443-B3","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1001\/jama.2011.370","article-title":"Association between opioid prescribing patterns and opioid overdose-related deaths","volume":"305","author":"Bohnert","year":"2011","journal-title":"JAMA"},{"key":"2026100311323645200_usag443-B4","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1016\/j.jacc.2020.11.002","article-title":"Cardiovascular complications of opioid use","volume":"77","author":"Krantz","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2026100311323645200_usag443-B5","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1093\/pm\/pnaa417","article-title":"The resurrection of interdisciplinary pain rehabilitation: outcomes across a Veterans Affairs collaborative","volume":"22","author":"Murphy","year":"2021","journal-title":"Pain Med"},{"key":"2026100311323645200_usag443-B6","author":"Department of Veterans Affairs, Veterans Health Administration","year":"2009"},{"key":"2026100311323645200_usag443-B7","first-page":"217","author":"Commission on Accreditation for Rehabilitation Facilities","year":"2025"},{"key":"2026100311323645200_usag443-B8","author":"Palyo","year":"2025"},{"key":"2026100311323645200_usag443-B9","doi-asserted-by":"publisher","first-page":"e72091","DOI":"10.2196\/72091","article-title":"Characterization and evaluation of Department of Veterans Affairs Commission on accreditation of rehabilitation facilities\u2013accredited interdisciplinary pain rehabilitation programs: Protocol for a mixed methods program evaluation","volume":"14","author":"Haun","year":"2025","journal-title":"JMIR Res Protoc."},{"key":"2026100311323645200_usag443-B10","author":"Turk","year":"2010"},{"key":"2026100311323645200_usag443-B11","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1037\/a0035514","article-title":"Interdisciplinary chronic pain management: past, present, and future","volume":"69","author":"Gatchel","year":"2014","journal-title":"Am Psychol"},{"key":"2026100311323645200_usag443-B12","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1097\/AJP.0000000000001243","article-title":"Comparing pain outcomes and treatment adherence between in-person and virtual interdisciplinary pain rehabilitation programs at the San Francisco VA Health Care System","volume":"40","author":"Murphy","year":"2024","journal-title":"Clin J Pain"},{"key":"2026100311323645200_usag443-B13","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1682\/JRRD.2014.10.0250","article-title":"Sex differences between veterans participating in interdisciplinary chronic pain rehabilitation","volume":"53","author":"Murphy","year":"2016","journal-title":"J Rehabil Res Dev"},{"key":"2026100311323645200_usag443-B14","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1097\/AJP.0b013e3182579935","article-title":"Opioid cessation and multidimensional outcomes after interdisciplinary chronic pain treatment","volume":"29","author":"Murphy","year":"2013","journal-title":"Clin J Pain"},{"key":"2026100311323645200_usag443-B15","author":"Department of Veterans Affairs, Veterans Health Administration","year":"2026"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article-pdf\/doi\/10.1093\/milmed\/usag443\/71576862\/usag443.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article-pdf\/doi\/10.1093\/milmed\/usag443\/71576862\/usag443.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T15:32:43Z","timestamp":1791041563000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article\/doi\/10.1093\/milmed\/usag443\/8860293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,3]]},"references-count":15,"URL":"https:\/\/doi.org\/10.1093\/milmed\/usag443","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,3]]},"article-number":"usag443"}}