Article
Public, Environmental & Occupational Health
Dominick DePhilippis, Gabriela Khazanov, Dana E. Christofferson, Carl Wayne Wesley, Jennifer L. Burden, Joseph Liberto, James R. McKay
Summary: This article describes the national implementation of contingency management in Veterans Affairs (VA) substance use disorder treatment programs, including its rationale, role of VA leadership, and training procedures. The results and outcomes of several CM pilot programs are provided, along with the challenges and lessons learned. The feasibility of implementing CM in smaller community-based VA facilities and remotely is also discussed.
PREVENTIVE MEDICINE
(2023)
Editorial Material
Medicine, General & Internal
Baligh R. Yehia, Stephan D. Fihn
Summary: To respond to declining numbers of veterans and impending budget constraints, the VA health care system can accelerate the transition to value-based care, optimize infrastructure, and strengthen engagement with employees and the public.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2021)
Article
Public, Environmental & Occupational Health
Claudia Der-Martirosian, William Neil Steers, Heather Northcraft, Karen Chu, Aram Dobalian
Summary: With the surge of the COVID-19 Omicron variant in the U.S., there is a need for more research on increasing vaccination rates. This study examines the characteristics of veterans who were vaccinated and identifies groups that are less likely to get vaccinated, providing insights for targeted interventions.
AMERICAN JOURNAL OF PREVENTIVE MEDICINE
(2022)
Article
Health Care Sciences & Services
Warren B. P. Pettey, Todd H. Wagner, Amy K. Rosen, Erin Beilstein-Wedel, Michael Shwartz, Megan E. Vanneman
Summary: The study found that although many veterans drove farther than needed to get cataract surgery in CC, this was not true for obtaining care in the VA. Our findings suggest that there may be additional reasons, besides driving distance, that affect whether Veterans choose CC and, if they do, where they seek CC.
Article
Obstetrics & Gynecology
Deirdre A. Quinn, Maria K. Mor, Florentina E. Sileanu, Xinhua Zhao, Lisa S. Callegari, Laurie C. Zephyrin, Daniel J. Frayne, Sonya Borrero
Summary: The study assessed the feasibility of using preconception health measures in a large healthcare system and found issues such as inadequate prenatal care, high obesity rates, and high rates of smoking and depression among female veterans.
OBSTETRICS AND GYNECOLOGY
(2021)
Article
Psychiatry
Mark Weiser, John M. Davis, Clayton H. Brown, Eric P. Slade, Li Juan Fang, Deborah R. Medoff, Robert W. Buchanan, Linda Levi, Michael Davidson, Julie Kreyenbuhl
Summary: The study compared the clinical effectiveness of oral and long-acting injectable antipsychotic medications used in the treatment of schizophrenia in the U.S. Department of Veterans Affairs health care system. Results indicated that clozapine, two of the LAI second-generation antipsychotics, and antipsychotic polypharmacy were associated with longer maintenance of the same antipsychotic therapy compared to the reference drug, oral olanzapine.
AMERICAN JOURNAL OF PSYCHIATRY
(2021)
Letter
Medicine, General & Internal
Andrew J. Read, Akbar K. Waljee, Charity S. Chen, Robert Holleman, Kyle E. Kumbier, Sameer D. Saini
Summary: This cohort study examines the prevalence of appropriate testing for incident anemia in a large cohort from a national integrated health care system.
Article
Medicine, General & Internal
John R. McQuaid, Andrew Buelt, Vincent Capaldi, Matthew Fuller, Fuad Issa, Adam Edward Lang, Charles Hoge, David W. Oslin, James Sall, Ilse R. Wiechers, Scott Williams
Summary: This article summarizes the joint clinical practice guideline approved by the U.S. Department of Veterans Affairs and the U.S. Department of Defense for the management of Major Depressive Disorder (MDD), including key recommendations on pharmacologic management, pharmacogenomics, psychotherapy, complementary and alternative therapies, and the use of telemedicine.
ANNALS OF INTERNAL MEDICINE
(2022)
Article
Neurosciences
Linda L. Chao
Summary: This study aimed to analyze the health status of Gulf War veterans who participated in research studies at the San Francisco VA Health Care System. The study found that veterans with Gulf War Illness had poorer health status, and those with Kansas GWI exclusionary conditions had the poorest health status. Furthermore, factors related to deployment experiences and exposures were also associated with veterans' health status.
FRONTIERS IN NEUROSCIENCE
(2023)
Article
Health Care Sciences & Services
Demetria M. McNeal, Kelty Fehling, P. Michael Ho, Peter Kaboli, Stephanie Shimada, Sameer D. Saini, Bradley Youles, Karen Albright
Summary: This study aims to develop a research roadmap for healthcare access by engaging diverse stakeholders and Veterans in the process. The Delphi approach was used to gather input from researchers and VA operational partners, resulting in five priority research questions. The perspectives of Veterans primarily focused on barriers to access, including communication issues and lack of resources or education.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2022)
Review
Surgery
Mariah Blegen, Jamie Ko, Garrett Salzman, Meron M. Begashaw, Jesus G. Ulloa, Mark Girgis, Paul Shekelle, Melinda Maggard-Gibbons
Summary: In response to concerns about healthcare access and long wait times within the Veterans Health Administration (VA), Congress passed the Choice Act of 2014 and the MISSION Act of 2018 to create a program for patients to receive care in non-VA sites of care, paid by VA. A review of recent evidence comparing surgical care between VA and non-VA delivered care found that VA surgical care has similar or better quality and safety outcomes compared to non-VA sites of care, but non-VA care shows better cost/efficiency outcomes. The expansion of eligibility for veterans to receive care in the community may not increase access to surgical procedures or improve quality, but it may lead to shorter inpatient stays and potentially lower costs.
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
(2023)
Review
Surgery
Kenneth A. Lipshy, Kamal Itani, Danny Chu, Anil Bahadursingh, Seth Spector, Kathleen Raman, Alan Dardik, Edith Tzeng, Garth H. Ballantyne, Preeti R. John, Brian Cmolik, James Maloney, Robert Kozol, Walter E. Longo
Summary: The vast achievements of the US Department of Veterans Affairs in advancing medicine over the past century have greatly benefited patients worldwide. Through collaborations with medical schools and the establishment of research and quality improvement programs, VA has led the world in healthcare progress, leading to numerous global successes.
Article
Neurosciences
Christopher B. Brady, Ian Robey, Thor D. Stein, Bertrand R. Huber, Jessica Riley, Nazifa Abdul Rauf, Keith R. Spencer, Gabriel Walt, Latease Adams, James G. Averill, Sean Walker, Ann C. McKee, Stephen P. Thomson, Neil W. Kowall
Summary: The study introduces the Gulf War Veterans' Illnesses Biorepository (GWVIB) as a resource for researching Gulf War illness (GWI) and related disorders. By recruiting Gulf War era veterans nationally and conducting annual follow-ups, the GWVIB ensures the collection of health data and postmortem neuropathological examination for tissue banking. Data as of September 2021 show significant enrolment of GWVs, with common neuropathologies such as ALS, CTE, and Lewy body disease observed in tissue samples. High-quality CNS tissue and health data from this well-characterized cohort will support ongoing research on GWI and related disorders.
Article
Multidisciplinary Sciences
Vera Yakovchenko, David A. Jacob, Shari S. Rogal, Timothy R. Morgan, Karine Rozenberg-Ben-Dror
Summary: The Veterans Health Administration (VA) implemented a national HCV population management dashboard to identify and treat HCV patients efficiently. The dashboard was widely used and received positive user feedback in terms of usability and acceptance.
Article
Anesthesiology
Catherine Chanfreau-Coffinier, Sony Tuteja, Leland E. Hull, Sally MacDonald, Olga Efimova, Jill Bates, Deepak Voora, David W. Oslin, Scott L. DuVall, Julie A. Lynch
Summary: The response to analgesic therapy is influenced by various factors, including genetics and drug interactions. This study aimed to evaluate the potential impact of pharmacogenetic (PGx) testing on the care of Veterans with noncancer pain who were prescribed opioids metabolized by the CYP2D6 gene. The results showed that a significant proportion of patients were at an elevated risk for undesirable responses to their opioid medication based on predicted phenotypes and drug-drug interactions. However, CYP2D6 testing was infrequently used, and the results were mainly utilized to optimize antidepressant treatments rather than pain medications. The findings suggest that utilizing PGx testing along with consideration of phenoconversion may enhance the precision medicine approach to pain management in Veterans.
