Supplemental Material for Racial and Ethnic Disparities in Clinical Outcomes Six Months After Receiving a PTSD Diagnosis in Veterans Health Administration

2019 ◽  
Vol 26 (8-9) ◽  
pp. 696-702 ◽  
Author(s):  
Sarah J Javier ◽  
Lara K Troszak ◽  
Stephanie L Shimada ◽  
D Keith McInnes ◽  
Michael E Ohl ◽  
...  

Abstract Objective To examine sociodemographic characteristics associated with use of My HealtheVet (MHV) by veterans living with HIV. Materials and Methods Veterans Health Administration administrative data were used to identify a cohort of veterans living with HIV in fiscal years 2011–2017. Descriptive analyses were conducted to examine demographic characteristics and racial/ethnic differences in MHV registration and tool use. Chi-Square tests were performed to assess associations between race/ethnicity and MHV registration and tool use. Results The highest proportion of registrants were non-Hispanic White veterans living with HIV (59%), followed by Hispanic/Latino (55%) and Black veterans living with HIV (40%). Chi-Square analyses revealed that: (1) MHV account registration was significantly lower for both Black and Hispanic/Latino veterans in comparison to White veterans and (2) Black MHV registrants were less likely to utilize any MHV tool compared with White MHV registrants including Blue Button record download, medication refills, secure messaging, lab, and appointment views. Discussion In line with prior research on personal health record (PHR) use among non-veteran populations, these findings show racial and ethnic inequities in MHV use among veterans living with HIV. Racial and ethnic minorities may be less likely to use PHRs for a myriad of reasons, including PHR privacy concerns, decreased educational attainment, and limited access to the internet. Conclusion This is the first study to examine racial and ethnic disparities in use of MHV tools by veterans living with HIV and utilizing Veterans Health Administration health care. Future research should examine potential moderating factors linked to decreased PHR use among racial and ethnic minority veterans, which could inform strategies to increase PHR use among vulnerable populations.


2017 ◽  
Vol 36 (6) ◽  
pp. 1086-1094 ◽  
Author(s):  
Donna L. Washington ◽  
W. Neil Steers ◽  
Alexis K. Huynh ◽  
Susan M. Frayne ◽  
Uchenna S. Uchendu ◽  
...  

Author(s):  
Timothy J. Holleran ◽  
Michael A. Napolitano ◽  
Hannah R. Crowder ◽  
Andrew D. Sparks ◽  
Jared L. Antevil ◽  
...  

Health Equity ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. 99-108 ◽  
Author(s):  
Michelle S. Wong ◽  
Katherine J. Hoggatt ◽  
W. Neil Steers ◽  
Susan M. Frayne ◽  
Alexis K. Huynh ◽  
...  

2017 ◽  
Vol 33 (5) ◽  
pp. 189-194 ◽  
Author(s):  
Chad Naville-Cook ◽  
Leroy Rhea ◽  
Mark Triboletti ◽  
Christina White

Background: Medication conversions occur frequently within the Veterans Health Administration. This manual process involves several pharmacists over an extended period of time. Macros can automate the process of converting a list of patients from one medication to a therapeutic alternative. Objectives: To develop a macro that would convert active rosuvastatin prescriptions to atorvastatin and to create an electronic dashboard to evaluate clinical outcomes. Methods: A conversion protocol was approved by the Pharmacy & Therapeutics Committee. A macro was developed using Microsoft Visual Basic. Outpatients with active prescriptions for rosuvastatin were reviewed and excluded if they had a documented allergy to atorvastatin or a significant drug-drug interaction. An electronic dashboard was created to compare safety and efficacy endpoints pre- and postconversion. Primary endpoints included low-density lipoprotein (LDL), creatine phosphokinase (CPK), aspartate transaminase (AST), alanine transaminase (ALT), and alkaline phosphatase. Secondary endpoints evaluated cardiovascular events, including the incidences of myocardial infarction, stroke, and stent placement. Results: The macro was used to convert 1520 patients from rosuvastatin to atorvastatin over a period of 20 hours saving $5760 in pharmacist labor. There were no significant changes in LDL, AST, ALT, or secondary endpoints ( P > .05). There was a significant increase in alkaline phosphatase ( P = .0035). Conclusions: A rapid mass medication conversion from rosuvastatin to atorvastatin saved time and money and resulted in no clinically significant changes in safety or efficacy endpoints. Macros and clinical dashboards can be applied to any Veterans Health Administration facility.


Crisis ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 376-383 ◽  
Author(s):  
Brooke A. Levandowski ◽  
Constance M. Cass ◽  
Stephanie N. Miller ◽  
Janet E. Kemp ◽  
Kenneth R. Conner

Abstract. Background: The Veterans Health Administration (VHA) health-care system utilizes a multilevel suicide prevention intervention that features the use of standardized safety plans with veterans considered to be at high risk for suicide. Aims: Little is known about clinician perceptions on the value of safety planning with veterans at high risk for suicide. Method: Audio-recorded interviews with 29 VHA behavioral health treatment providers in a southeastern city were transcribed and analyzed using qualitative methodology. Results: Clinical providers consider safety planning feasible, acceptable, and valuable to veterans at high risk for suicide owing to the collaborative and interactive nature of the intervention. Providers identified the types of veterans who easily engaged in safety planning and those who may experience more difficulty with the process. Conclusion: Additional research with VHA providers in other locations and with veteran consumers is needed.


Sign in / Sign up

Export Citation Format

Share Document