Lisa M McAndrew1, L Alison Phillips2, Drew A Helmer3, Kieran Maestro4, Charles C Engel5, Lauren M Greenberg6, Nicole Anastasides7, Karen S Quigley8. 1. War Related Illness and Injury Study Center, Department of Veterans Affairs New Jersey Health Care System, United States; Department of Educational and Counseling Psychology, University at Albany, United States. Electronic address: Lisa.mcandrew@va.gov. 2. War Related Illness and Injury Study Center, Department of Veterans Affairs New Jersey Health Care System, United States; Iowa State University, Department of Psychology, United States. Electronic address: alisonp@iastate.edu. 3. War Related Illness and Injury Study Center, Department of Veterans Affairs New Jersey Health Care System, United States; Rutgers University Jersey Medical School, United States. Electronic address: Drew.Helmer@va.gov. 4. War Related Illness and Injury Study Center, Department of Veterans Affairs New Jersey Health Care System, United States; Department of Educational and Counseling Psychology, University at Albany, United States. Electronic address: kmaestro@albany.edu. 5. Behavioral and Policy Sciences, RAND Corporation, United States. Electronic address: cengel@rand.org. 6. War Related Illness and Injury Study Center, Department of Veterans Affairs New Jersey Health Care System, United States. Electronic address: Lauren.greenberg@va.gov. 7. War Related Illness and Injury Study Center, Department of Veterans Affairs New Jersey Health Care System, United States. Electronic address: Nicole.anastasides@va.gov. 8. Center for Healthcare Outcomes and Implementation Research, Edith Nourse Rogers Memorial VA Hospital, Bedford, MA, United States; Department of Psychology, Northeastern University, Boston, MA, United States. Electronic address: k.quigley@neu.edu.
Abstract
OBJECTIVE: Patients with medically unexplained syndromes (MUS) often do not receive appropriate healthcare. A critical time for effective healthcare is the inception of MUS. The current study examined data from a prospective longitudinal study of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) soldiers to understand the relationship of increasing physical symptom burden to healthcare utilization. METHODS: Data was examined from a prospective study of OEF/OIF soldiers assessed before and one year after deployment (n=336). Physical symptom burden was measured with the Patient Health Questionnaire (PHQ-15). Analyses were conducted with polynomial regression and response surface analysis (RSA). RESULTS: Increases in physical symptom burden predicted greater healthcare utilization one year after deployment: primary care practitioner (slope=-0.26, F=4.07, p=0.04), specialist (slope=-0.43, F=8.67, p=0.003), allied health therapy (e.g., physical therapy) (slope=-0.41, F=5.71, p=0.02) and mental health (slope=-0.32, F=4.04, p=0.05). There were no significant difference in utilization between those with consistently high levels and those with increases in physical symptom burden. CONCLUSION: This is the first prospective study to examine, and show, a relationship between onset of clinically significant physical symptoms and greater healthcare utilization. Our data suggest that patients with increasing physical symptom burden have the same level of healthcare as patients with chronic physical symptom burden. Needed next steps are to better understand the quality of care at inception and determine how to intervene so that recommended approaches to care are provided from the onset.
OBJECTIVE:Patients with medically unexplained syndromes (MUS) often do not receive appropriate healthcare. A critical time for effective healthcare is the inception of MUS. The current study examined data from a prospective longitudinal study of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) soldiers to understand the relationship of increasing physical symptom burden to healthcare utilization. METHODS: Data was examined from a prospective study of OEF/OIF soldiers assessed before and one year after deployment (n=336). Physical symptom burden was measured with the Patient Health Questionnaire (PHQ-15). Analyses were conducted with polynomial regression and response surface analysis (RSA). RESULTS: Increases in physical symptom burden predicted greater healthcare utilization one year after deployment: primary care practitioner (slope=-0.26, F=4.07, p=0.04), specialist (slope=-0.43, F=8.67, p=0.003), allied health therapy (e.g., physical therapy) (slope=-0.41, F=5.71, p=0.02) and mental health (slope=-0.32, F=4.04, p=0.05). There were no significant difference in utilization between those with consistently high levels and those with increases in physical symptom burden. CONCLUSION: This is the first prospective study to examine, and show, a relationship between onset of clinically significant physical symptoms and greater healthcare utilization. Our data suggest that patients with increasing physical symptom burden have the same level of healthcare as patients with chronic physical symptom burden. Needed next steps are to better understand the quality of care at inception and determine how to intervene so that recommended approaches to care are provided from the onset.
Authors: April F Mohanty; Lisa M McAndrew; Drew Helmer; Matthew H Samore; Adi V Gundlapalli Journal: J Gen Intern Med Date: 2018-09 Impact factor: 5.128
Authors: Lisa M McAndrew; Sarah Slotkin; Justin Kimber; Kieran Maestro; L Alison Phillips; Jessica L Martin; Marcus Credé; Austin Eklund Journal: J Couns Psychol Date: 2019-06-17
Authors: Hieke Barends; Femke Botman; Ella Walstock; Nikki Claassen-van Dessel; Johannes C van der Wouden; Tim Olde Hartman; Joost Dekker; Henriëtte E van der Horst Journal: Br J Gen Pract Date: 2022-06-20 Impact factor: 6.302
Authors: Nicole M Walley; Loren D M Pena; Stephen R Hooper; Heidi Cope; Yong-Hui Jiang; Allyn McConkie-Rosell; Camilla Sanders; Kelly Schoch; Rebecca C Spillmann; Kimberly Strong; Alexa T McCray; Paul Mazur; Cecilia Esteves; Kimberly LeBlanc; Anastasia L Wise; Vandana Shashi Journal: BMC Health Serv Res Date: 2018-08-22 Impact factor: 2.655