Featured Publications
Evaluation of Complementary and Integrative Health Approaches Among US Veterans with Musculoskeletal Pain Using Propensity Score Methods
Han L, Goulet JL, Skanderson M, Bathulapalli H, Luther SL, Kerns RD, Brandt CA. Evaluation of Complementary and Integrative Health Approaches Among US Veterans with Musculoskeletal Pain Using Propensity Score Methods. Pain Medicine 2018, 20: 90-102. PMID: 29584926, PMCID: PMC6329442, DOI: 10.1093/pm/pny027.Peer-Reviewed Original ResearchConceptsIntegrative health approachesPS matchingCIH exposureMusculoskeletal painPropensity score methodsSelf-rated pain intensityHealth approachHigher pain intensity ratingsPain intensity outcomesChronic musculoskeletal painPain intensity ratingsIPTW modelsRetrospective cohortPain intensityChronic painClinical visitsInitial diagnosisChiropractic careUS veteransBaseline differencesTreatment weightingExposure groupPainScore methodTreatment effectivenessOpioid dosing trends over eight years among US Veterans with musculoskeletal disorders after returning from service in support of recent conflicts
Han L, Allore H, Goulet J, Bathulapali H, Skanderson M, Brandt C, Haskell S, Krebs E. Opioid dosing trends over eight years among US Veterans with musculoskeletal disorders after returning from service in support of recent conflicts. Annals Of Epidemiology 2017, 27: 563-569.e3. PMID: 28890282, PMCID: PMC5647654, DOI: 10.1016/j.annepidem.2017.08.015.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnalgesics, OpioidChronic PainDrug PrescriptionsElectronic PrescribingFemaleHumansMaleMental HealthMiddle AgedMusculoskeletal DiseasesOpioid-Related DisordersPrescription DrugsStress Disorders, Post-TraumaticUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthYoung AdultConceptsHigh-dose prescribingOpioid prescriptionsMental health diagnosesMusculoskeletal disordersDaily morphine equivalentsHealth diagnosisHigh-dose therapyLong-term opioidsHigh-dose prescriptionsAverage daily dosePosttraumatic stress disorderMorphine equivalentsDose therapyDaily dosePatient characteristicsChronic painUS veteransOdds ratioPrescribingStress disorderBaseline periodGeographic confoundingVeteransPrescriptionOpioids
2024
Leveraging Electronic Health Records to Assess Residential Mobility Among Veterans in the Veterans Health Administration
Wang K, Hendrickson Z, Miller M, Abel E, Skanderson M, Erdos J, Womack J, Brandt C, Desai M, Han L. Leveraging Electronic Health Records to Assess Residential Mobility Among Veterans in the Veterans Health Administration. Medical Care 2024, 62: 458-463. PMID: 38848139, DOI: 10.1097/mlr.0000000000002017.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationElectronic health recordsResidential addressesHealth recordsHealth AdministrationLeveraging electronic health recordsInfluence health care utilizationVeterans Health Administration dataAssociations of sociodemographicsHealth care utilizationHealth care systemPatient's residential addressCross-sectional analysisGeneralized logistic regressionCare utilizationHealth systemResidential mobilitySubstance use disordersCare systemPatient's residenceLogistic regressionVeteransMultinomial outcomesHealthOdds
2023
Dissemination and implementation of age‐friendly care and geriatric emergency department accreditation at Veterans Affairs hospitals
Hwang U, Runels T, Han L, Gruber E, McQuown C, Ragsdale L, Jetter E, Rossomano N, Javier D. Dissemination and implementation of age‐friendly care and geriatric emergency department accreditation at Veterans Affairs hospitals. Academic Emergency Medicine 2023, 30: 270-277. PMID: 36653961, DOI: 10.1111/acem.14665.Peer-Reviewed Original ResearchConceptsVA emergency departmentEmergency departmentOlder veteransED visitsVA Corporate Data WarehouseAge-friendly careIndex ED visitVeterans Affairs hospitalYears of ageCorporate Data WarehouseScreening prevalencePoor outcomeStandardization of practiceMean ageVisit encountersPotential confoundingEmergency careGreater oddsExtended careDemographic dataOlder adultsLevel 1Observational evaluationCarePandemic year
2022
Post-9/11 deployment history and the incidence of breast cancer among women veterans
Gaffey A, Han L, Ramsey C, Skanderson M, Dziura J, Driscoll M, Burg M, Brandt C, Bastian L, Haskell S. Post-9/11 deployment history and the incidence of breast cancer among women veterans. Annals Of Epidemiology 2022, 77: 98-102. PMID: 36470323, DOI: 10.1016/j.annepidem.2022.11.010.Peer-Reviewed Original ResearchConceptsOEF/OIF deploymentBreast cancerWomen veteransHealthcare utilizationHormone replacement therapy useRetrospective cohort studyVeterans Affairs (VA) careHealthy soldier effectOEF/OIFCohort studyTherapy useBC incidenceHormonal contraceptivesLifestyle factorsPrimary careBC diagnosisLower incidenceOperations Enduring Freedom/Iraqi FreedomWomenIncidenceGreater likelihoodIraqi FreedomVeteransCancerCareMental Health Diagnoses are Not Associated With Indicators of Lower Quality Pain Care in Electronic Health Records of a National Sample of Veterans Treated in Veterans Health Administration Primary Care Settings
Dobscha SK, Luther SL, Kerns RD, Finch DK, Goulet JL, Brandt CA, Skanderson M, Bathulapalli H, Fodeh SJ, Hahm B, Bouayad L, Lee A, Han L. Mental Health Diagnoses are Not Associated With Indicators of Lower Quality Pain Care in Electronic Health Records of a National Sample of Veterans Treated in Veterans Health Administration Primary Care Settings. Journal Of Pain 2022, 24: 273-281. PMID: 36167230, PMCID: PMC9898089, DOI: 10.1016/j.jpain.2022.08.009.Peer-Reviewed Original ResearchConceptsPain care qualityQuality pain careMental health conditionsPrimary care cliniciansVeterans Health AdministrationPain carePCQ scoresHealth conditionsCare cliniciansUse disordersCare qualitySevere musculoskeletal painRetrospective cohort studyPrimary care visitsGeneral medical carePrimary care settingElectronic health record dataFinal adjusted modelMental health diagnosesEquation Poisson modelsHealth record dataBipolar disorder diagnosisSubstance use disordersAlcohol use disorderPost-traumatic stress disorderMilitary 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 impactRisk Factors Associated with Healthcare Utilization for Spine Pain
Higgins DM, Han L, Kerns RD, Driscoll MA, Heapy AA, Skanderson M, Lisi AJ, Mattocks KM, Brandt C, Haskell SG. Risk Factors Associated with Healthcare Utilization for Spine Pain. Pain Medicine 2022, 23: 1423-1433. PMID: 34999899, DOI: 10.1093/pm/pnab351.Peer-Reviewed Original ResearchConceptsSpine pain careSpine painHealthcare utilizationPain careRisk factorsPain episodesObservation periodNew episodesMultivariable logistic regression modelPotential risk factorsOutpatient visit dataLogistic regression analysisMental health conditionsBaseline observation periodLogistic regression modelsBaseline characteristicsOutpatient visitsClinical correlatesContinued careLower oddsPainVisit dataContinued episodesHealth conditionsCare
2021
Measuring pain care quality in the Veterans Health Administration primary care setting
Luther SL, Finch DK, Bouayad L, McCart J, Han L, Dobscha SK, Skanderson M, Fodeh SJ, Hahm B, Lee A, Goulet JL, Brandt CA, Kerns RD. Measuring pain care quality in the Veterans Health Administration primary care setting. Pain 2021, 163: e715-e724. PMID: 34724683, PMCID: PMC8920945, DOI: 10.1097/j.pain.0000000000002477.Peer-Reviewed Original ResearchConceptsPain care qualityPattern of documentationSevere pain intensityFrequency of documentationPresence of painSite of painPrimary care providersPrimary care settingCare quality indicatorsQuality improvement initiativesTotal PCQ scoresPatient characteristicsPain intensityPain carePain impactPCQ scoresCare settingsCare providersMusculoskeletal disordersFurther evaluationPainCare qualityHealthcare facilitiesImprovement initiativesUnique visitsSex Differences in Use of a Clinical Complexity Measure to Predict Primary Care Utilization
Haskell SG, Han L, Abel EA, Bastian L, Driscoll M, Dziura J, Burg MM, Skanderson M, Brandt CA. Sex Differences in Use of a Clinical Complexity Measure to Predict Primary Care Utilization. Journal Of Women's Health 2021, 31: 71-78. PMID: 34388023, DOI: 10.1089/jwh.2021.0103.Peer-Reviewed Original ResearchConceptsPrimary care utilizationCare utilizationWomen veteransCare Assessment Need (CAN) scoreComplex high-risk patientsHigh-risk patientsRisk stratification toolPotential confounding factorsCorporate Data WarehouseSex differencesVA careVisit utilizationCare coordinationHigher oddsReproductive healthConfounding factorsVeterans AffairsPsychosocial variablesStrong associationQuintileWomenNeed scoresMenVeteransGood predictive accuracyAssociation Between Potentially Inappropriate Medications and 30-Day Post–Hospital Discharge Outcomes in US Veterans
Allore HG, Gnjidic D, Skanderson M, Han L. Association Between Potentially Inappropriate Medications and 30-Day Post–Hospital Discharge Outcomes in US Veterans. Annals Of Pharmacotherapy 2021, 56: 256-263. PMID: 34282638, PMCID: PMC8770754, DOI: 10.1177/10600280211032072.Peer-Reviewed Original ResearchConceptsAdjusted hazard ratioRisk of mortalityHospital dischargeMean ageAcute care hospital readmissionPrimary care clinic visitsCohort's mean agePrevalence of PIMsInappropriate medication useRisk of readmissionHospital discharge outcomesEmergency room visitsHealth care utilizationAdverse drug eventsCentral nervous systemCause mortalityInappropriate medicationsPIM useClinic visitsHazard ratioProspective cohortDischarge outcomesHospital readmissionMedication useOlder inpatients
2020
Concurrent Hospice Care and Cancer-Directed Treatment for Advanced Lung Cancer and Receipt of Aggressive Care at the End of Life in the Veteran's Health Administration
Presley CJ, Han L, O'Leary JR, Zhu W, Corneau E, Chao H, Shamas T, Rose M, Lorenz K, Levy CR, Mor V, Gross CP. Concurrent Hospice Care and Cancer-Directed Treatment for Advanced Lung Cancer and Receipt of Aggressive Care at the End of Life in the Veteran's Health Administration. Journal Of Palliative Medicine 2020, 23: 1038-1044. PMID: 32119800, PMCID: PMC7404822, DOI: 10.1089/jpm.2019.0485.Peer-Reviewed Original ResearchConceptsNonsmall cell lung cancerVeterans Health AdministrationStage IV nonsmall cell lung cancerCancer-directed treatmentEnd of lifeAggressive careConcurrent careHealth AdministrationVHA facilitiesLung cancerHospice careConcurrent hospice careLung cancer careAdvanced lung cancerCell lung cancerMultilevel logistic regression modelsLogistic regression modelsPrimary outcomeCancer careHospice useStudy periodCareLast monthPatientsVeterans
2011
Antidepressant Use and Cognitive Deficits in Older Men: Addressing Confounding by Indications with Different Methods
Han L, Kim N, Brandt C, Allore HG. Antidepressant Use and Cognitive Deficits in Older Men: Addressing Confounding by Indications with Different Methods. Annals Of Epidemiology 2011, 22: 9-16. PMID: 22037381, PMCID: PMC4054866, DOI: 10.1016/j.annepidem.2011.10.004.Peer-Reviewed Original ResearchConceptsDepression-related diagnosisAntidepressant useDepression symptomsOlder personsPropensity scoreHopkins Verbal Learning TestHypertensive menAntidepressant medicationIndication biasVerbal Learning TestMedical recordsPotential confoundingCumulative exposureOlder menCognitive impairmentMemory deficitsCognitive deficitsMultiple linear regressionLinear regressionLearning TestApparent associationScoresSymptomsDiagnosisIndications
2007
Effects of Statin Use on Muscle Strength, Cognition, and Depressive Symptoms in Older Adults
Agostini JV, Tinetti ME, Han L, McAvay G, Foody JM, Concato J. Effects of Statin Use on Muscle Strength, Cognition, and Depressive Symptoms in Older Adults. Journal Of The American Geriatrics Society 2007, 55: 420-425. PMID: 17341246, DOI: 10.1111/j.1532-5415.2007.01071.x.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCognitionCohort StudiesComorbidityConnecticutDepressionDrug Therapy, CombinationDrug UtilizationFemaleGeriatric AssessmentHumansHydroxymethylglutaryl-CoA Reductase InhibitorsLongitudinal StudiesMaleMuscle StrengthNeuropsychological TestsPrimary Health CareProspective StudiesRisk AssessmentVeteransConceptsStatin usersMuscle strengthTest Part BStatin useDepression scoresEpidemiologic Studies Depression Scale scoreOutpatient primary care clinicsOlder adultsConcomitant medication useProximal muscle strengthObservational cohort studyPeripheral vascular diseasePrimary care clinicsDepression Scale scoresHigh-risk participantsHydroxymethyl glutaryl coenzymeCommunity-dwelling veteransCommunity-dwelling male participantsGreater comorbidityStatin therapyCohort studyMedian durationStatin prescriptionMedication useCare clinics