2009 — Satisfaction and Adherence to Problem-Solving Treatment for Gulf War Illness
Lead/Presenter: Lisa McAndrew,
McAndrew LM, NJ WRIISC; Helmer DA, NJ WRIISC; Hyde J, Center for Healthcare Organization and Implementation Research; Sherman S, Manhattan; Bair M, VA HSR&D Center for Health Information and Communication;
The VA and the DoD have invested hundreds of millions of dollars to understand Gulf War Illness (GWI) and develop new treatments. In contrast, there has not been a trial of the best model of care to translate this research into clinical practice. Translating research into practice is a key goal of the VA Gulf War Strategic Plan. One reason there haven't been trials of the best model of care for GWI is that there haven't been evidence-based treatments. This is changing; we conducted the second largest trial for GWI and are finding both problem-solving treatment and health coaching have efficacy. To guide implementation, we are planning a effectiveness-implementation hybrid study to determine the best models to deliver these and other treatments to Veterans with GWI. The objective of this Veteran Engagement Panel is to obtain feedback on our proposed study, "Collaborative Specialty Care for Gulf War Illness" (I01HX002835-02, PI-McAndrew).
This proposal is under review at HSRandD.
1. Discuss current barriers and facilitators to treatment for GWI. 2. Present and obtain feedback on our proposed tele-health symptom clinic (collaborative specialty care) 3. Discuss acceptability and appropriateness of telephone, video and internet treatment delivery 4. Present and obtain feedback on the best methods to educate primary care providers (control condition) 5. Present and obtain feedback on outcome measures and assessments to ensure their relevance and importance to veterans
Understanding how to best deliver care for a condition that is a national VA priority and has a low prevalence at any one Veterans Affairs Medical Center has implications for improving care of GWI and other relatively rare conditions. These include Parkinson's disease, rheumatologic disorders (e.g., systemic sclerosis), genetic disorders, and environmental exposures (e.g., Airborne Hazards).
The question of the best model of care to disseminate treatments for GWI is currently being debated by Office of Patient Care Services, the Research Advisory Committee for Gulf War Veterans' Illnesses, and War Related Illness and Injury Study Center (WRIISC) leadership. The information from this panel will be immediately be used to guide our planned hybrid effectiveness/implementation study. It will also be used to guide the WRIISC efforts to improve the care of GWI in the VA.