2024
A clinician's guide to the 2023 VA/DoD Clinical Practice Guideline for Management of Posttraumatic Stress Disorder and Acute Stress Disorder
Lang A, Hamblen J, Holtzheimer P, Kelly U, Norman S, Riggs D, Schnurr P, Wiechers I. A clinician's guide to the 2023 VA/DoD Clinical Practice Guideline for Management of Posttraumatic Stress Disorder and Acute Stress Disorder. Journal Of Traumatic Stress 2024, 37: 19-34. PMID: 38184799, DOI: 10.1002/jts.23013.Peer-Reviewed Original ResearchClinical practice guidelinesAcute stress disorderPractice guidelinesPosttraumatic stress disorderStress disorderCPG recommendationsVA/DOD Clinical Practice GuidelineDefense Clinical Practice GuidelineFeasibility of interventionsEvidence-based practiceClinical algorithmClinician's GuideAvailable evidenceDisordersGuidelinesPatientsCliniciansRecommendationsContextual assessment
2022
Comparison of mental health outcomes of augmenting medications for patients with posttraumatic stress disorder: A national veterans affairs study
Ranney R, Maguen S, Woods A, Seal K, Neylan T, Bernardy N, Wiechers I, Ryder A, Cohen B. Comparison of mental health outcomes of augmenting medications for patients with posttraumatic stress disorder: A national veterans affairs study. Journal Of Evaluation In Clinical Practice 2022, 29: 191-202. PMID: 35709244, DOI: 10.1111/jep.13726.Peer-Reviewed Original ResearchConceptsEmergency room visitsPosttraumatic stress disorderPsychiatric emergency room visitsAugmenting medicationsRoom visitsMental health outcomesPsychiatric hospitalizationHospitalization/emergency room visitsHealth outcomesStress disorderPTSD symptomsVeterans Affairs studyDiagnosis of PTSDMedication groupClinical trialsAdditional interventionsMedicationsBaseline levelsPatientsVeterans AffairsNew prescriptionsElectronic recordsVisitsHospitalizationSymptoms
2021
Trends in Medication Prescribing in Patients With PTSD From 2009 to 2018: A National Veterans Administration Study.
Holder N, Woods A, Neylan TC, Maguen S, Seal KH, Bernardy N, Wiechers I, Ryder A, Urbieta AM, Cohen BE. Trends in Medication Prescribing in Patients With PTSD From 2009 to 2018: A National Veterans Administration Study. The Journal Of Clinical Psychiatry 2021, 82 PMID: 34004087, DOI: 10.4088/jcp.20m13522.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAntipsychotic AgentsDrug PrescriptionsHumansLongitudinal StudiesMaleMiddle AgedPractice Patterns, Physicians'Psychotropic DrugsRetrospective StudiesSelective Serotonin Reuptake InhibitorsSerotonin and Noradrenaline Reuptake InhibitorsStress Disorders, Post-TraumaticUnited StatesUnited States Department of Veterans AffairsVeteransConceptsPosttraumatic stress disorderPercentage of patientsVeterans Health AdministrationVHA careAdjunctive medicationsOutpatient prescription recordsSSRIs/SNRIsVeterans Administration studyClinical practice guidelinesICD-10 codesAdverse side effectsEvidence-based psychotherapiesPsychotic spectrum disordersAAP useMedication classesBenzodiazepine prescriptionsMedication prescribingPrescription recordsSymptom improvementNational cohortPractice guidelinesMedicationsSide effectsICD-9Patients
2018
Patient centered medical homes did not improve access to timely follow-up after ED visit
Chou SC, Rothenberg C, Agnoli A, Wiechers I, Lott J, Voorhees J, Bernstein SL, Venkatesh AK. Patient centered medical homes did not improve access to timely follow-up after ED visit. The American Journal Of Emergency Medicine 2018, 36: 854-858. PMID: 29452920, DOI: 10.1016/j.ajem.2018.01.070.Peer-Reviewed Original ResearchConceptsPrimary care followPrimary care practicesPCMH designationCare followAffordable Care ActAppointment availabilityCare practicesEmergency department dischargeGreater New HavenED visitsED patientsTimely followInsurance statusOutpatient practiceInsurance typeHours appointmentED diagnosisMedical homeLocal cliniciansPractice characteristicsSignificant associationPatientsFollowStandardized scriptPractice improvement
2017
Development and Applications of the Veterans Health Administration’s Stratification Tool for Opioid Risk Mitigation (STORM) to Improve Opioid Safety and Prevent Overdose and Suicide
Oliva EM, Bowe T, Tavakoli S, Martins S, Lewis ET, Paik M, Wiechers I, Henderson P, Harvey M, Avoundjian T, Medhanie A, Trafton JA. Development and Applications of the Veterans Health Administration’s Stratification Tool for Opioid Risk Mitigation (STORM) to Improve Opioid Safety and Prevent Overdose and Suicide. Psychological Services 2017, 14: 34-49. PMID: 28134555, DOI: 10.1037/ser0000099.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationSuicide-related eventsPredictive risk modelAdverse eventsRisk factorsRisk mitigation interventionsOpioid-related adverse eventsVHA electronic medical recordsSuicide-related adverse eventsOpioid risk mitigationOpioid Safety InitiativeHigh-risk patientsNaloxone distribution programsElectronic medical recordsOpioid prescribingOpioid analgesicsVHA patientsStratification toolMedical recordsOverdose educationPatientsHealth AdministrationMortality dataPatient identificationRisk model
2013
Prescribing of Psychotropic Medications to Patients Without a Psychiatric Diagnosis
Wiechers IR, Leslie DL, Rosenheck RA. Prescribing of Psychotropic Medications to Patients Without a Psychiatric Diagnosis. Psychiatric Services 2013, 64: 1243-1248. PMID: 23999894, DOI: 10.1176/appi.ps.201200557.Peer-Reviewed Original ResearchConceptsMental health specialty carePotential medical indicationsProportion of patientsPsychotropic medicationsPsychiatric diagnosisSpecialty careMedical indicationsComorbid medical conditionsGeneral medical illnessMajority of recipientsOlder patientsYounger patientsMedical illnessClaims databaseResults AltogetherDesirable careMedical conditionsMedicationsPatientsMultivariate analysisPrivate insuranceDiagnosisCareFurther studiesSeverity
2012
The Role of Consultation-Liaison Psychiatrists in Improving Health Care of Patients with Schizophrenia
Wiechers IR, Freudenreich O. The Role of Consultation-Liaison Psychiatrists in Improving Health Care of Patients with Schizophrenia. Journal Of The Academy Of Consultation-Liaison Psychiatry 2012, 54: 22-27. PMID: 23194936, DOI: 10.1016/j.psym.2012.07.008.Peer-Reviewed Original ResearchImpact of a Metabolic Screening Bundle on Rates of Screening for Metabolic Syndrome in a Psychiatry Resident Outpatient Clinic
Wiechers IR, Viron M, Stoklosa J, Freudenreich O, Henderson DC, Weiss A. Impact of a Metabolic Screening Bundle on Rates of Screening for Metabolic Syndrome in a Psychiatry Resident Outpatient Clinic. Academic Psychiatry 2012, 36: 118-121. PMID: 22532201, DOI: 10.1176/appi.ap.10090138.Peer-Reviewed Original ResearchConceptsElectronic medical recordsAntipsychotic medicationMedical recordsMetabolic syndromeIndividual patient electronic medical recordsMetabolic screeningSecond-generation antipsychoticsMetabolic syndrome screeningPatients' electronic medical recordsCardiometabolic side effectsRate of documentationRates of screeningQuality improvement interventionsResident outpatient clinicOutpatient clinicResident clinicQI interventionsAudit periodSide effectsQuarterly auditsPatientsMedicationsAntipsychoticsSyndromeClinic
2008
Behavioral observations reflected on consultation requests from primary medical-surgical services: Are they predictive of delirium diagnosis and outcomes?
Xiong GL, Wiechers IR, Bourgeois JA, Gagliardi JP. Behavioral observations reflected on consultation requests from primary medical-surgical services: Are they predictive of delirium diagnosis and outcomes? Journal Of Psychosomatic Research 2008, 66: 177-181. PMID: 19154861, DOI: 10.1016/j.jpsychores.2008.08.003.Peer-Reviewed Original ResearchConceptsMedical-surgical teamConsultation requestsHighest likelihood ratioDiagnosis of deliriumSystemic medical conditionsFinal clinical diagnosisMedical-surgical servicesClassification of patientsLower mortality rateDelirium subtypesLikelihood ratioReadmission ratesClinical outcomesDEP groupDelirium outcomesDelirium diagnosisMultivariate regression modelCognitive dysfunctionMedical conditionsPsychosomatic servicesDeliriumConsult requestsMortality rateBehavior disturbancesPatients
2000
If patients with schizophrenia have small brains, why don't they have small heads?
Friedman L, Wiechers I, Cerny C, Schulz S, Buckley P. If patients with schizophrenia have small brains, why don't they have small heads? Schizophrenia Research 2000, 42: 1-6. PMID: 10706980, DOI: 10.1016/s0920-9964(99)00098-5.Peer-Reviewed Original Research