2024
Prescription Drug Prices: An AAN Position Statement.
Santoro J, Sico J, Burke J, Sarkar K, Turbes M, Evans D, Jordan J. Prescription Drug Prices: An AAN Position Statement. Neurology 2024, 102: e209132. PMID: 38335469, DOI: 10.1212/wnl.0000000000209132.Peer-Reviewed Original ResearchConceptsHigh cost of medicationNeurological disordersDevelopment of novel therapeuticsNeurological diseasesOrphan Drug ActTherapeutic optionsCost of medicationsHigh-value careCost of prescription drugsPrescription drug pricesRare diseaseTreat rare diseasesPatientsNovel therapeuticsTreat neurological disordersDrug ActCost containment effortsChronic neurological conditionsEffective prescription medicationsMedicationPrescriber accessPrescription medicationsTherapyHealthcare systemApproval pathway
2022
Frequency, Demographics, Comorbidities, and Health Care Utilization by Veterans With Migraine
Seng EK, Fenton BT, Wang K, Lipton RB, Ney J, Damush T, Grinberg AS, Skanderson M, Sico JJ. Frequency, Demographics, Comorbidities, and Health Care Utilization by Veterans With Migraine. Neurology 2022, 99: e1979-e1992. PMID: 36100439, PMCID: PMC9651466, DOI: 10.1212/wnl.0000000000200888.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationHealth care utilizationStudy periodCare utilizationHealth AdministrationOne-year period prevalenceOverweight/obesityMental health disordersChi-square testStudent's t-testMilitary sexual traumaAnnual encountersHeadache comorbidityPain comorbiditiesCohort entryCommon comorbiditiesPain disordersTotal cohortAnnual incidenceHealthcare utilizationHigher proportionPeriod prevalenceEmergency departmentMigraine carePrimary careCharacteristics and Gender Differences of Headache in the Veterans Health Administration
Sico JJ, Seng E, Wang K, Skanderson M, Schindler E, Ney JP, Lorenze N, Kimber A, Lindsey H, Grinberg AS, Kuruvilla D, Higgins D, Graham G, Sandbrink F, Scholten J, Shapiro RE, Lipton RB, Fenton B. Characteristics and Gender Differences of Headache in the Veterans Health Administration. Neurology 2022, 99: e1993-e2005. PMID: 36100437, PMCID: PMC9651459, DOI: 10.1212/wnl.0000000000200905.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationHeadache diagnosisHealthcare utilizationIncidence rateHeadache careHeadache typesHealth AdministrationSociodemographic characteristicsMilitary-related exposuresAge-adjusted incidenceEmergency department utilizationElectronic health record dataRetrospective cohort designType of headacheHigh incidence rateTraumatic brain injuryUnited States veteransHealth record dataPost-traumatic stress disorderGender differencesMilitary sexual traumaHeadache disordersBrain injuryHeadache specialistsCohort designMilitary sexual trauma and incident hypertension: a 16-year cohort study of young and middle-aged men and women
Gaffey AE, Rosman L, Sico JJ, Haskell SG, Brandt CA, Bathulapalli H, Han L, Dziura J, Skanderson M, Burg MM. Military sexual trauma and incident hypertension: a 16-year cohort study of young and middle-aged men and women. Journal Of Hypertension 2022, 40: 2307-2315. PMID: 35983872, DOI: 10.1097/hjh.0000000000003267.Peer-Reviewed Original ResearchConceptsIncident hypertensionRisk factorsPsychiatric disordersMultivariate Cox proportional hazards modelVeterans Health Administration dataGreater riskCox proportional hazards modelTrauma-related psychiatric disordersMiddle-aged veteransCardiovascular risk factorsBaseline blood pressureElevated cardiovascular riskLarge prospective cohortHealth Administration dataMiddle-aged menProportional hazards modelSex-specific analysesPosttraumatic stress disorderMilitary sexual traumaCardiovascular riskCohort studyProspective cohortBlood pressureTreatment attenuatesCardiovascular impactComplementary and integrative medicine perspectives among veteran patients and VHA healthcare providers for the treatment of headache disorders: a qualitative study
Kuruvilla DE, Lindsey H, Grinberg AS, Goldman RE, Riley S, Baird S, Fenton BT, Sico JJ, Damush TM. Complementary and integrative medicine perspectives among veteran patients and VHA healthcare providers for the treatment of headache disorders: a qualitative study. BMC Complementary Medicine And Therapies 2022, 22: 22. PMID: 35078450, PMCID: PMC8790919, DOI: 10.1186/s12906-022-03511-6.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationVeteran patientsHeadache managementClinical providersBackgroundThe Veterans Health AdministrationFavorable adverse effect profileVHA healthcare providersAdverse effect profileManagement of veteransChronic headache managementCIM modalitiesWhole health systemEffect profileHeadache centerChronic headacheHeadache disordersPatients' perceptionsHeadache treatmentSafe additionPatientsTreatment efficacyIntegrative medicineHealth AdministrationProviders' perceptionsHealthcare providersThe Primary Care Management of Headache: Synopsis of the 2020 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline
Sico JJ, Macedo F, Lewis J, Spevak C, Vogsland R, Ford A, Skop K, Sall J. The Primary Care Management of Headache: Synopsis of the 2020 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline. Military Medicine 2022, 187: e1091-e1102. PMID: 35022782, DOI: 10.1093/milmed/usab490.Peer-Reviewed Original ResearchConceptsClinical practice guidelinesPractice guidelinesDefense Clinical Practice GuidelineJoint clinical practice guidelineTrustworthy clinical practice guidelinesPractice Work GroupMedication overuse headachePrimary care managementPreferences of patientsGuideline development panelMedicine's tenetsPharmacologic managementRecommendations AssessmentOveruse headacheGuideline panelCare managementHeadacheDevelopment panelVeterans AffairsClinical stakeholdersPatientsGuidelinesIndividual needsDepartmentPrevention
2021
Depression as a Risk Factor for Incident Ischemic Stroke Among HIV‐Positive Veterans in the Veterans Aging Cohort Study
Sico JJ, Kundu S, So‐Armah K, Gupta SK, Chang C, Butt AA, Gibert CL, Marconi VC, Crystal S, Tindle HA, Freiberg MS, Stewart JC. Depression as a Risk Factor for Incident Ischemic Stroke Among HIV‐Positive Veterans in the Veterans Aging Cohort Study. Journal Of The American Heart Association 2021, 10: e017637. PMID: 34169726, PMCID: PMC8403311, DOI: 10.1161/jaha.119.017637.Peer-Reviewed Original ResearchConceptsHIV-positive peopleBaseline antidepressant useCerebrovascular risk factorsRisk of strokeRisk factorsAlcohol use disorderStroke riskAntidepressant useUse disordersCocaine useSociodemographic characteristicsTraditional cerebrovascular risk factorsVeterans Aging Cohort StudyCox proportional hazards modelBackground HIV infectionHIV-specific factorsIndividual antiretroviral agentsAntiretroviral therapy useBaseline cardiovascular diseaseIndependent risk factorAging Cohort StudyIschemic stroke riskHIV-positive veteransProportional hazards modelUninfected veterans
2020
Community‐Acquired Pneumonia and Risk of Cardiovascular Events in People Living With HIV
Zifodya JS, Duncan MS, So‐Armah K, Attia EF, Akgün KM, Rodriguez‐Barradas M, Marconi VC, Budoff MJ, Bedimo RJ, Alcorn CW, Hoo G, Butt AA, Kim JW, Sico JJ, Tindle HA, Huang L, Tate JP, Justice AC, Freiberg MS, Crothers K. Community‐Acquired Pneumonia and Risk of Cardiovascular Events in People Living With HIV. Journal Of The American Heart Association 2020, 9: e017645. PMID: 33222591, PMCID: PMC7763776, DOI: 10.1161/jaha.120.017645.Peer-Reviewed Original ResearchConceptsCommunity-acquired pneumoniaCVD risk factorsCVD eventsRisk factorsCAP severityHIV infectionHIV statusSevere community-acquired pneumoniaVeterans Aging Cohort StudyIncident CVD eventsCardiovascular disease eventsMultivariable-adjusted modelsAging Cohort StudyCox regression analysisDate of admissionMultivariable-adjusted analysesHigher mortality riskBackground HospitalizationCAP hospitalizationsHIV-uninfectedCardiovascular eventsIncident CVDCohort studyCVD riskUS veteransAssessment of the Protocol-Guided Rapid Evaluation of Veterans Experiencing New Transient Neurological Symptoms (PREVENT) Program for Improving Quality of Care for Transient Ischemic Attack
Bravata DM, Myers LJ, Perkins AJ, Zhang Y, Miech EJ, Rattray NA, Penney LS, Levine D, Sico JJ, Cheng EM, Damush TM. Assessment of the Protocol-Guided Rapid Evaluation of Veterans Experiencing New Transient Neurological Symptoms (PREVENT) Program for Improving Quality of Care for Transient Ischemic Attack. JAMA Network Open 2020, 3: e2015920. PMID: 32897372, PMCID: PMC7489850, DOI: 10.1001/jamanetworkopen.2020.15920.Peer-Reviewed Original ResearchConceptsTransient ischemic attackQuality of careIschemic attackElectronic health record toolsRecurrent vascular eventsDiverse medical centersGuideline-recommended processesQuality improvement interventionsProportion of veteransHealth care systemImplementation periodIntervention associationsQI supportVascular eventsMost patientsPrimary outcomeMean ageCare existIntervention periodSymptom interventionMedical CenterQI interventionsMAIN OUTCOMEHigh riskTimely managementAssociation of prescription opioids and incident cardiovascular risk factors among post-9/11 Veterans
Chui PW, Gordon KS, Dziura J, Burg MM, Brandt CA, Sico JJ, Leapman MS, Cavanagh CE, Rosman L, Haskell S, Becker WC, Bastian LA. Association of prescription opioids and incident cardiovascular risk factors among post-9/11 Veterans. Preventive Medicine 2020, 134: 106036. PMID: 32097753, DOI: 10.1016/j.ypmed.2020.106036.Peer-Reviewed Original ResearchConceptsCVD risk factorsLong-term opioid therapyCurrent smoking statusRisk factorsOpioid useOpioid therapySmoking statusCardiovascular diseaseHigh riskLong-term exposureIncident cardiovascular risk factorsModifiable CVD risk factorsPrevalent CVD risk factorsFirst primary care visitCardiovascular risk factorsPrimary care visitsBaseline periodElectronic health record dataMain outcome measuresHealth record dataOpioid prescriptionsCare visitsPrescription opioidsMain exposureOutcome measures
2019
Modelling care quality for patients after a transient ischaemic attack within the US Veterans Health Administration
Arling G, Sico JJ, Reeves MJ, Myers L, Baye F, Bravata DM. Modelling care quality for patients after a transient ischaemic attack within the US Veterans Health Administration. BMJ Open Quality 2019, 8: e000641. PMID: 31909209, PMCID: PMC6937041, DOI: 10.1136/bmjoq-2019-000641.Peer-Reviewed Original ResearchMeSH KeywordsAdministrative Claims, HealthcareAdultAgedAged, 80 and overEmergency Service, HospitalFemaleHumansIschemic Attack, TransientMaleMiddle AgedNeurologyPatient AdmissionQuality of Health CareReferral and ConsultationRetrospective StudiesStrokeTime FactorsUnited StatesUnited States Department of Veterans AffairsVeteransConceptsTransient ischemic attackCharlson Comorbidity IndexVeterans Health AdministrationHigher Charlson comorbidity indexUS Veterans Health AdministrationInpatient admissionsNeurological consultationNeurology consultationEmergency departmentIschemic attackPreventive careHealth AdministrationCare qualitySpeech deficitsHigher CCI scoresModerate potency statinRecurrent vascular eventsStroke center designationHistory of dementiaPreventive care qualityAntithrombotic medicationComorbidity indexCCI scoreED visitsRetrospective cohortPolysomnography Utilization in Veterans Presenting Acutely with Ischemic Stroke or Transient Ischemic Attack
Koo BB, Sico JJ, Myers LJ, Perkins AJ, Levine D, Miech EJ, Damush TM, Rattray N, Homoya B, Ferguson J, Myers J, Zhang Y, Bravata DM. Polysomnography Utilization in Veterans Presenting Acutely with Ischemic Stroke or Transient Ischemic Attack. Cerebrovascular Diseases 2019, 48: 179-183. PMID: 31722335, DOI: 10.1159/000504406.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaComorbidityFemaleHealth Services AccessibilityHealth StatusHumansIschemic Attack, TransientMaleMiddle AgedPolysomnographyPractice Guidelines as TopicPractice Patterns, Physicians'Predictive Value of TestsPrognosisRisk FactorsSleep Apnea, ObstructiveStrokeTime FactorsUnited StatesUnited States Department of Veterans AffairsVeterans HealthConceptsTransient ischemic attackAcute ischemic strokeObstructive sleep apneaVeterans Administration Medical CenterTreatment of OSAIschemic strokeIschemic attackClinical dataExact testVA Corporate Data WarehouseCerebrovascular risk factorsMixed-effects logistic regressionFisher's exact testCorporate Data WarehouseEffects logistic regressionTwo-sample t-testAcute strokeClinical characteristicsHospital dischargeHeart failureSleep apneaFunctional outcomeRisk factorsUS veteransRecent guidelinesProcesses of Care Associated With Risk of Mortality and Recurrent Stroke Among Patients With Transient Ischemic Attack and Nonsevere Ischemic Stroke
Bravata DM, Myers LJ, Reeves M, Cheng EM, Baye F, Ofner S, Miech EJ, Damush T, Sico JJ, Zillich A, Phipps M, Williams LS, Chaturvedi S, Johanning J, Yu Z, Perkins AJ, Zhang Y, Arling G. Processes of Care Associated With Risk of Mortality and Recurrent Stroke Among Patients With Transient Ischemic Attack and Nonsevere Ischemic Stroke. JAMA Network Open 2019, 2: e196716. PMID: 31268543, PMCID: PMC6613337, DOI: 10.1001/jamanetworkopen.2019.6716.Peer-Reviewed Original ResearchMeSH KeywordsBrain IschemiaEligibility DeterminationFemaleHumansIschemic Attack, TransientLong Term Adverse EffectsMaleMiddle AgedMortalityOutcome and Process Assessment, Health CarePatient Care ManagementPrognosisRecurrenceRisk AssessmentRisk FactorsSeverity of Illness IndexStrokeUnited StatesVeterans Health ServicesConceptsTransient ischemic attackRecurrent ischemic strokeIschemic strokeRisk of deathRecurrent strokeProcess of careLower oddsMedication intensificationIschemic attackAtrial fibrillationVeterans Affairs emergency departmentAntihypertensive medication classesMortality 1 yearManagement of patientsMultivariable logistic regressionRisk of mortalityMultiple comparisonsCarotid artery imagingCause mortalityLipid managementMedication classesStatin medicationStatin therapyCohort studyStroke riskAmerican Academy of Neurology members' preparedness to treat sexual and gender minorities.
Rosendale N, Ostendorf T, Evans DA, Weathers A, Sico JJ, Randall J, Hinson HE. American Academy of Neurology members' preparedness to treat sexual and gender minorities. Neurology 2019, 93: 159-166. PMID: 31201295, DOI: 10.1212/wnl.0000000000007829.Peer-Reviewed Original ResearchConceptsNeurologic careSGM patientsAmerican AcademyHealth care servicesGender minority patientsNeurologic healthNeurologic illnessMost neurologistsMinority patientsSelf-reported knowledgeResponse rateFuture educational offeringsCare servicesPatientsSocial determinantsClinical preparednessMinority of respondentsNeurologistsSGM individualsGender identitySGM identitiesSexual orientationAAN membersMost respondentsCareDepression and all‐cause mortality risk in HIV‐infected and HIV‐uninfected US veterans: a cohort study
So‐Armah K, Gupta S, Kundu S, Stewart J, Goulet J, Butt A, Sico J, Marconi, Crystal S, Rodriguez‐Barradas M, Budoff M, Gibert C, Chang C, Bedimo R, Freiberg. Depression and all‐cause mortality risk in HIV‐infected and HIV‐uninfected US veterans: a cohort study. HIV Medicine 2019, 20: 317-329. PMID: 30924577, PMCID: PMC6459698, DOI: 10.1111/hiv.12726.Peer-Reviewed Original ResearchConceptsHIV infectionMajor depressive disorderHIV statusDepressive symptomsMedian followCause mortalityDepressive disorderMortality riskVeterans Aging Cohort Study (VACS) dataDeath rateMajor depressive disorder diagnosisFirst clinic visitCause mortality riskPHQ-9 scoresNinth Revision codesPatient Health QuestionnaireDepressive disorder diagnosisPHQ-9 dataCohort study dataContribution of depressionDepression definitionsClinic visitsCohort studyComorbid conditionsEligible participants
2018
Uncertainty as a Key Influence in the Decision To Admit Patients with Transient Ischemic Attack
Homoya BJ, Damush TM, Sico JJ, Miech EJ, Arling GW, Myers LJ, Ferguson JB, Phipps MS, Cheng EM, Bravata DM. Uncertainty as a Key Influence in the Decision To Admit Patients with Transient Ischemic Attack. Journal Of General Internal Medicine 2018, 34: 1715-1723. PMID: 30484102, PMCID: PMC6712185, DOI: 10.1007/s11606-018-4735-9.Peer-Reviewed Original ResearchConceptsTransient ischemic attackVA Medical CenterTIA patientsChart review dataAdmission ratesTIA admissionsTIA careABCD2 scoreIschemic attackChart reviewAdministrative dataSubsequent vascular eventsSecondary prevention strategiesSubset of patientsQuality improvement interventionsHigher admission ratesQuality of careKey ResultsProvidersTimely workupVascular eventsEmergency departmentInpatient settingMedical CenterHigh riskPatientsAssociation between admission haematocrit and mortality among men with acute ischaemic stroke
Sico JJ, Myers LJ, Fenton BJ, Concato J, Williams LS, Bravata DM. Association between admission haematocrit and mortality among men with acute ischaemic stroke. Stroke And Vascular Neurology 2018, 3: 160. PMID: 30294472, PMCID: PMC6169611, DOI: 10.1136/svn-2018-000149.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeIschemic strokeAdmission haematocritAdjusted ORsChronic Health Evaluation IIIVeterans Health Administration facilitiesFirst year post strokeHours of admissionRisk of deathHaematocrit valuesMultivariate logistic regressionYear post strokeAcute PhysiologyHospital mortalityMedical comorbiditiesPoststroke mortalityStroke severityBlood transfusionSevere anemiaPost strokeHeart diseaseMedical recordsPatient outcomesCardiovascular conditionsPatientsQuality of Care for Veterans With Transient Ischemic Attack and Minor Stroke
Bravata DM, Myers LJ, Arling G, Miech EJ, Damush T, Sico JJ, Phipps MS, Zillich AJ, Yu Z, Reeves M, Williams LS, Johanning J, Chaturvedi S, Baye F, Ofner S, Austin C, Ferguson J, Graham GD, Rhude R, Kessler CS, Higgins DS, Cheng E. Quality of Care for Veterans With Transient Ischemic Attack and Minor Stroke. JAMA Neurology 2018, 75: 419-427. PMID: 29404578, PMCID: PMC5885264, DOI: 10.1001/jamaneurol.2017.4648.Peer-Reviewed Original ResearchConceptsTransient ischemic attackMinor strokeEmergency departmentElements of careDay 2Ischemic attackDay 7Federal fiscal year 2014Intensive care unit stayDeep vein thrombosis prophylaxisVeterans Health Administration systemCare qualityReceipt of thrombolysisRecurrent vascular eventsStroke care qualityVHA emergency departmentGuideline-concordant careLength of stayGuideline-recommended processesProcess of careHealth Administration systemQuality of careHemoglobin A1c measurementsElectronic quality measuresHealth care systemAssociation of Human Immunodeficiency Virus Infection and Risk of Peripheral Artery Disease
Beckman JA, Duncan MS, Alcorn CW, So-Armah K, Butt AA, Goetz M, Tindle HA, Sico J, Tracy RP, Justice AC, Freiberg MS. Association of Human Immunodeficiency Virus Infection and Risk of Peripheral Artery Disease. Circulation 2018, 138: 255-265. PMID: 29535090, PMCID: PMC6050082, DOI: 10.1161/circulationaha.117.032647.Peer-Reviewed Original ResearchConceptsRisk of PADIncident PAD eventsPeripheral artery diseaseHuman immunodeficiency virusCD4 cell countTraditional atherosclerotic risk factorsPAD risk factorsAtherosclerotic risk factorsPAD eventsRisk factorsCell countUninfected veteransCD4 cellsArtery diseaseHIV infectionHIV statusViral loadCells/Peripheral artery disease eventsPrior peripheral artery diseaseHuman immunodeficiency virus (HIV) infectionVeterans Aging Cohort StudyHIV-1 ribonucleic acidHIV infection statusHIV viral loadAssociation of neurologist care with headache expenditures: A population-based, longitudinal analysis
Ney JP, Sico JJ, Klein BC, Magliocco B, Callaghan BC, Esper G. Association of neurologist care with headache expenditures: A population-based, longitudinal analysis. Cephalalgia 2018, 38: 1876-1884. PMID: 29504480, DOI: 10.1177/0333102418762572.Peer-Reviewed Original ResearchConceptsNeurologist careAmbulatory care visitsLongitudinal cohort studyMedical Expenditure Panel SurveyResults Eight hundredHealth care costsMean annual expenditureCare visitsCohort studyHealthcare utilizationClinical variablesDiagnostic codesAdjusted associationsCare costsHeadache sufferersHealthcare expendituresYear oneCareHeadacheSignificant reductionAdult respondentsLongitudinal analysisAssociationYear twoAnnual expenditure