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Center for Care Delivery and Outcomes Research

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CCDOR Veteran Engagement Panels inform VACO Leadership (Spring 2023)

The Pain/Opioid CORE (Co‐PI: Dr. Erin Krebs; CORE Manager: Dr. Tracy Sides) collaborated with Dr. Amy Kilbourne to engage Veterans stakeholders in determining research priorities for the Pain and Opioid Use AMP. The Pain/Opioid CORE engagement staff facilitated visits with three different Veteran engagement panels: 1) The Pain/Opioid CORE Veteran Engagement Panel, 2) CCDOR’s VIPR+ Panel, & 3) Colorado‐based Substance Abuse and Recovery Veteran Engagement Board. Dr. Kilbourne informed the Pain CORE that this feedback from Veterans made a difference in the priority selection. Two upcoming research funding cycles are using these priorities as selection criteria for submitted proposals (VA ORD Winter Funding Cycle & NIH HEAL Initiative Award for Veteran‐specific research). 

Michele Spoont collaborates with VA National Center for PTSD (NCPTSD) to address disparities in access to evidence‐based psychotherapies (EBPs) for PTSD

Following findings from HSR&D‐funded research demonstrating racial disparities in access to EBPs for PTSD, Dr. Michele Spoont led an operations‐funded initiative with partners at the VA NCPTSD’sMentoring Program aimed at reducing those disparities. In collaboration with these partners, Dr. Spoont developed a process to  conduct a root cause analysis in PTSD Clinical Teams to identify likely contributors to disparities and elicit possible intervention targets to reduce such inequities. In FY23, the process was implemented within a PTSD Clinical Team with previously demonstrated racial disparities in EBP access; the root cause analysis will be completed, and the team will implement resulting interventions of their choice in FY24. 

Orly Vardeny gave a briefing to Dr. Ramoni and other ORD leaders on her NIH ACTIVE‐4A trial 

This trial tested the safety/efficacy of several novel therapeutic strategies in hospitalized COVID patients and created a query to identify VA institutions with a high‐level of hospital admissions for COVID‐19. When initiated in 2021, this was one of the first NIH‐NHLBI funded platform trials with a VA Network included. At the briefing, Dr. Vardeny shared lessons learned from a VA‐network approach to participation in externally funded (non‐VA) clinical trials. These learnings informed VA network participation in the current NIAID‐funded STRIVE study, examining additional therapies in COVID‐19.

COMPASS study referral system is continuing after study completion

The COMPASS study (Co‐PIs: Shannon Kehle‐Forbes & Hildi Hagedorn),which provides psychotherapy for PTSD for Veterans with PTSD who are also starting treatment for a substance use disorder (SUD), implemented a cross‐clinic referral process for the study. The clinicians on the Substance Use Team at the Durham VA found the process so valuable that they lobbied leadership that the service continue once the study ended. As one clinician wrote to leadership, “Rapid access to PTSD treatment for veterans entering SUD treatment is extremely valuable. It would be hard to overestimate the value of this in my view. The COMPASS timeline has allowed veterans to get connected to PTSD treatment very quickly when they are already motivated and ready to engage. From the perspective of an SUD clinician, it really has been a “game changer” for those veterans where concurrent SUD and PTSD treatment is indicated.” Due to providers’ enthusiasm, leadership dedicated an FTE to continue the referral program once study recruitment ended in FY23.

Laura Meis’ IIR 15‐322 study improved PTSD treatment retention and mental health providers continue to use skills learned

This study aimed to improve the adherence to Prolonged Exposure (PE) therapy for Veterans with PTSD through engaging their families in care. PE is an evidence‐based psychotherapy that has resulted in clinically significant PTSD symptom relief; however, adherence to this therapy can be poor. In this study, 16 mental health providers at 3 VA facilities were trained in delivering Family Supported Prolonged Exposure Therapy (FSPE). In FY23 (over a year after study completion), 12 of these  providers reported that they are continuing to involve Veterans’ families in PTSD treatment and that the experience and skills they gained during the study have improved their comfort and increased their frequency in doing so. Results from the study indicated that FSPE improved treatment retention by 17% overall, and 20% among veterans who included an intimate partner in their care. The main manuscript describing study findings is in preparation.



Infographic for Gustavson study Dr. Allison Gustavson is co-leading VHA’s Long COVID Community of Practice, which aims to foster collaboration within and outside the VA to disseminate information and clinical resources on Long-COVID to providers on a national level. Dr. Gustavson also published a paper (“Stakeholder and Data-Driven Fall Screen in a Program of All-Inclusive Care for the Elderly: Quality Improvement Initiative") and infographic to address fall rates in the J of Geriatric Physical Therapy.
SPACE icon CCDOR researcher Dr. Erin Krebs and team worked with a panel of Veterans to develop an infographic to share results of the SPACE study with the community. Click the link below to view and share a copy of the infographic. 

HOMEFRONT icon Dr. Laura Meis collaborated with CCDOR’s Communication Committee to create a visual abstract of her article, “Sticking It Out in Trauma-Focused Treatment for PTSD: It Takes a Village,” that was published in the Journal of Consulting and Clinical Psychology.

Infographic for Pain CORE Dr. Tracy Sides and Dr. Erin Krebs, along with the Pain/Opioid Consortium of Research team, launched an initiative to produce a series of “infographics” which summarize results from a health services research study that is relevant to patients with chronic pain, opioid use, or opioid use disorder. Veteran input informs each stage of the production process. The infographic highlighted here shares information about Cognitive Behavioral Therapy for Chronic Pain in Veterans. Click the link below to view and share a copy of the infographic. All current Pain/Opioid CORE infographics are available on their website.