Gulf War and Health Treatment for Chronic Multisymptom Illness (2013) / Chapter Skim
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8 Recommendations
8 Recommendations
Pages 183-194
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From page 183... ...
4. Improving the collection and quality of data on outcomes and satisfaction of care of veterans who have CMI and are treated in VA health care facilities.
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From page 184... ...
Additional studies, not conducted in 1991 Gulf War veterans, also reported a net benefit of exercise or group CBT in reducing symptoms associated with CMI (Bleichhardt et al., 2004; Lidbeck, 2003; Martin et al., 2007; Peters et al., 2002; Rief et al., 2002; Zaby et al., 2008)
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From page 185... ...
. However, the programs have not been consistently implemented throughout the VA health care system, and they have not been adequately evaluated to learn about their strengths and weaknesses so that changes can be made to improve the quality of care.
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From page 186... ...
s Once a veteran has been identified as having CMI and has entered the VA health care system, the next step is to provide comprehensive care for the veteran, not only for CMI but also for any comorbid conditions. VA has developed multiple clinical practice guidelines (CPGs)
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From page 187... ...
Team members can include a project manager, primary care clinicians, nurse care managers, mental health clinicians, social workers, and other specialists as needed. The move to a medical home model of care is relatively recent in VA's health care system, and implementation is ongoing (Reisinger et al., 2012)
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From page 188... ...
As noted in Chapter 7, VA can be viewed as the largest health education and health professional training institution in the nation. It has active interprofessional team training programs in palliative care and geriatrics and has recently extended interprofessional team-based training into a small number of primary care settings (VA, 2011)
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From page 189... ...
should develop learning, or peer, networks to introduce new information, norms, and skills related to managing veterans who have chronic multi symptom illness. Because many veterans receive care outside the VA health care system, clinicians in private practice should be offered the opportunity to be included in the learning networks and VA should have a specific focus on community outreach.
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From page 190... ...
The Department of Veterans Affairs (VA) should provide the resources needed to expand its data collection efforts to include a national system for the robust capture, aggregation, and analysis of data on the structures, processes, and outcomes of care delivery and on the satisfaction with care among patients who have chronic multisymptom illness so that gaps in clinical care can be evalu ated, strategies for improvement can be planned, long-term outcomes of treatment can be assessed, and this information can be disseminated to VA health care facilities.
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From page 191... ...
Recommendation 8-13. The Department of Veterans Affairs should fund and conduct studies of interventions that evidence suggests may hold promise for treatment of chronic multisymptom illness.
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2011. Partnering urban academic medical centers and rural primary care clinicians to provide complex chronic disease care.
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2002. A randomized controlled trial of group aerobic exercise in primary care patients with persistent, unexplained physical symptoms.
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2009c. Clinical Practice Guideline: Management of Major Depressive Disorder (MDD)
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