Improving the care of veterans

Hobson, Alexandra; Curtis, Alexa Colgrove

doi:10.1002/2327-6924.12506

Cited by 9 publications

(2 citation statements)

References 53 publications

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“…This use pattern reflects the rapidly changing roles in the first years of DAA implementation [ 18 , 19 ]. As others have reported, clinical pharmacists and advanced practice providers were central to DAA treatment initiation in recent years [ 20 , 21 ]. Clearer understanding of how providers integrated the HCVDB in care processes and the resulting efficiencies needs further study.…”

Section: Discussionmentioning

confidence: 99%

User experience of a hepatitis c population management dashboard in the Department of Veterans Affairs

Yakovchenko

Jacob²,

Rogal

et al. 2023

PLoS ONE

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Background The Veterans Health Administration (VA) is the largest integrated healthcare organization in the US and cares for the largest cohort of individuals with hepatitis C (HCV). A national HCV population management dashboard enabled rapid identification and treatment uptake with direct acting antiviral agents across VA hospitals. We describe the HCV dashboard (HCVDB) and evaluate its use and user experience. Methods A user-centered design approach created the HCVDB to include reports based on the HCV care continuum: 1) 1945–1965 birth cohort high-risk screening, 2) linkage to care and treatment of chronic HCV, 3) treatment monitoring, 4) post-treatment to confirm cure (i.e., sustained virologic response), and 5) special populations of unstably housed Veterans. We evaluated frequency of usage and user experience with the System Usability Score (SUS) and Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) instruments. Results Between November 2016 and July 2021, 1302 unique users accessed the HCVDB a total of 163,836 times. The linkage report was used most frequently (71%), followed by screening (13%), sustained virologic response (11%), on-treatment (4%), and special populations (<1%). Based on user feedback (n = 105), the mean SUS score was 73±16, indicating a good user experience. Overall acceptability was high with the following UTAUT2 rated from highest to least: Price Value, Performance Expectancy, Social Influence, and Facilitating Conditions. Conclusions The HCVDB had rapid and widespread uptake, met provider needs, and scored highly on user experience measures. Collaboration between clinicians, clinical informatics, and population health experts was essential for dashboard design and sustained use. Population health management tools have the potential for large-scale impacts on care timeliness and efficiency.

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Section: Discussionmentioning

confidence: 99%

User experience of a hepatitis c population management dashboard in the Department of Veterans Affairs

Yakovchenko

Jacob²,

Rogal

et al. 2023

PLoS ONE

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“…Our study provides several important practical implications. Considering almost 20% of primary care visits within the VA Health care System are conducted by nurse practitioners (NPs; Hobson & Curtis, 2017), NPs should be adequately equipped for their work with military veterans. Since our results suggest that there is a strong positive relationship between CVD knowledge and resilience among military veterans with PTSD, the services provided by NPs should incorporate the best practices of trauma-informed care (TIC), particularly in primary care settings.…”

Section: Implications For Practicementioning

confidence: 99%

Cardiovascular disease knowledge, risk factors, and resilience among US veterans with and without post-traumatic stress disorder

Angosta

Reyes

Cross

et al. 2020

J Am Assoc Nurse Pract

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Background: Cardiovascular disease (CVD) is the leading cause of death in the United States and the leading cause of hospitalization and disability among the US veterans. Information about CVD knowledge and risk factors, and connection between psychological health and CVD among veterans transitioning from the military are limited. Purpose: We examined the existing knowledge of CVD and its risk factors among the US veterans with and without post-traumatic stress disorder (PTSD), and the relationship between knowledge, risk factors, resilience, and PTSD. Methods: A total of 104 veterans participated in our study by responding to the Primary Care PTSD Screen for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Heart Disease Fact Questionnaire (HDFQ) knowledge scale, and Connor-Davidson Resilience Scale 10. Data were extracted from the online Qualtrics survey software into SPSS (v. 25) for analysis. Results: Mean age was 52.3 years, mostly males (85.6%), married (72.1%), employed (54.8%), and with college education. Most were in the Navy or Air Force (72.1%) and served in a war (68.0%). Hypertension, high cholesterol, and obesity were the most common CVD risk factors reported. Average CVD knowledge score was 85%. Marines scored higher on resilience than other branches of the military. Seventeen percent reported having PTSD. The Connor-Davidson Resilience Scale 10 was significantly correlated with the HDFQ in the probable PTSD group (r = .589, p = .013). Implications for practice: Our study provides information about the knowledge and risk factors of CVD among veterans and insights about interventions needed to improve CV health. Nurse practitioners should assess the CV and psychological health of veterans and screen for PTSD to provide appropriate care and referral.

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