From the Chief Research and Development Officer
Veteran-centric care for chronic illnesses
There are very few things that are universal in this world, but every one of our lives has been touched by chronic illness. I, myself, lost my husband to heart disease when he was just 47 years old, and my mother survived a heart attack at the age of 53. I am sure that all of you have your own sorrows caused by chronic illness. In addition to these concerns, our Veterans are disproportionately affected by certain chronic illnesses like traumatic brain injury and posttraumatic stress disorder.
There are more than 5 million Veterans actively receiving care in the Veterans Health Administration (VHA). VA is committed to supporting a strong research and development program and promoting bench-to-bedside initiatives that help bring new research applications directly to patient care.
In fact, that was the theme of this year's Research Week—"Bridging the Gap"—held May 15-19. Investigators all over the country shared the latest developments and accomplishments in VA research at special events to celebrate our research accomplishments and the Veterans who make those accomplishments possible.
In this issue, we have taken the opportunity to highlight a number of research initiatives and programs that are especially relevant to caring for Veterans who live with chronic illness.
During the past year, Health Services Research and Development held two state of the art conferences to discuss the latest evidence-based research on chronic pain management and weight management.
Veterans have twice the rate of accidental poisoning deaths compared to the U.S. population as a whole, according to a study in the journal Medical Care. Most often, that is due to opioid pain medicine overdose. VA research is key to finding new ways to help Veterans manage their chronic pain. Investigators are looking into nondrug approaches for pain management that don't have the potential for addiction, like mindfulness meditation and cognitive behavioral therapy.
In addition, VA researchers with support from the VA Quality Enhancement Research Initiative are partnering with VA leaders to launch a national risk management program for Veterans who are at risk for opioid use disorder and other critical events including suicide, with the goal of informing more patient-centered approaches to pain management.
Another problem that affects Veterans disproportionately is obesity. While the prevalence of obesity in the general population is 38 percent, it is 41 percent among Veterans who use the VHA for their health care, according to a study in the Journal of General Internal Medicine. Obesity confers a much higher risk for many complex illnesses like heart disease, diabetes, and stroke. VA researchers are investigating new ways to help Veterans to lose weight.
Within VA, there has been quite a bit of work done to explore complementary and integrative health approaches to chronic illness and mental health, like meditation, yoga, and acupuncture. In this issue, we interview Dr. Karen Saban, a nurse researcher at Edward Hines, Jr. VA Hospital in Chicago. Saban has spent her career investigating the science of the brain and the unique problems that Veterans encounter. Her latest research project involves the use of mindfulness techniques to reduce stress, which can contribute to heart disease.
Posttraumatic stress disorder can be a devastating disease. It often affects all facets of a Veteran's life after service. It also can also negatively affect heart health. In this issue, we review a collection of VA studies that look at the effects of PTSD on heart health. As a group, Veterans are much more likely to develop heart disease—perhaps traumatic stress plays a role in this. VA researchers are examining the prevalence of heart disease in specific groups of Veterans and looking for the mechanisms at work in those populations.
VA has been instrumental in research that strives to support Veterans and their caregivers to find the most effective preventions and treatments for chronic illnesses. We approach this mission inspired by the resolve of our Veterans, with perseverance and a commitment to excellence, so that fewer lives will be touched by the challenges of chronic illness.
Rachel B. Ramoni, D.M.D., Sc.D.
Chief Research and Development Officer