Journal of general internal medicine
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Randomized Controlled Trial
Effect of a National VHA Medical Scribe Pilot on Provider Productivity, Wait Times, and Patient Satisfaction in Cardiology and Orthopedics.
Section 507 of the VA MISSION Act of 2018 mandated a 2-year pilot study of medical scribes in the Veterans Health Administration (VHA), with 12 VA Medical Centers randomly selected to receive scribes in their emergency departments or high wait time specialty clinics (cardiology and orthopedics). The pilot began on June 30, 2020, and ended on July 1, 2022. ⋯ Given the potential improvements in productivity and wait times with no change in patient satisfaction, our results suggest that scribes may be a useful tool to improve access to VHA care. However, participation in the pilot by sites and providers was voluntary, which could have implications for scalability and what effects could be expected if scribes were introduced to the care process without buy-in. Cost was not considered in this analysis but is an important factor for future implementation.
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Randomized Controlled Trial
Yoga Versus Education for Veterans with Chronic Low Back Pain: a Randomized Controlled Trial.
Yoga is effective for chronic low back pain (cLBP) in civilians but understudied among Veterans. ⋯ NCT02224183.
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Randomized Controlled Trial
A Randomized Clinical Trial of Clinician-Supported PTSD Coach in VA Primary Care Patients.
Posttraumatic stress disorder (PTSD) is common in primary care patients; however, evidence-based treatments are typically only available in specialty mental healthcare settings and often not accessed. ⋯ A structured 4-session intervention designed to align with patient preferences for care resulted in more patient-reported PTSD symptom relief, greater utilization of mental health treatment, and overall treatment satisfaction than TAU, but not more clinician-rated PTSD symptom relief or engagement in specialty mental health.
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The Veterans Health Administration (VHA) is in need of population health approaches to address overweight and obesity-related diseases. BMI serves as a simple, blunt metric to monitor these efforts. However, emerging research has demonstrated that healthcare weigh-ins contribute to weight stigma which paraodoxically is associated with weight gain. An alternative metric is urgently needed for VHA's MOVE!® Weight Management Program and other eating- and weight-related services. ⋯ Findings support the reliability and construct validity of the WE-QOL Scale. The WE-QOL Scale has potential to provide a standardized population health metric that could be used as a screening tool and clinical reminder to identify, refer, and assess outcomes for Veterans with weight and disordered eating issues. Future research could be targeted at using this measure to improve patient care and quality of care.
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Housing security is a key social determinant of behavior related to health outcomes. ⋯ The REDD-CAT Housing Security Measure provides a reliable and valid assessment of housing affordability, safety, and home features in people with type 2 diabetes mellitus. Future work is needed to establish the clinical utility of this measure in other clinical populations.