2022
Gender Differences in Guideline-Directed Medical Therapy for Cardiovascular Disease Among Young Veterans
Dhruva SS, Dziura J, Bathulapalli H, Rosman L, Gaffey AE, Davis MB, Brandt CA, Haskell SG. Gender Differences in Guideline-Directed Medical Therapy for Cardiovascular Disease Among Young Veterans. Journal Of General Internal Medicine 2022, 37: 806-815. PMID: 36042086, PMCID: PMC9481764, DOI: 10.1007/s11606-022-07595-1.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyIncident coronary artery diseaseCoronary artery diseaseHeart failureMedical therapyCardiovascular diseaseWomen veteransDiagnosis of HFAldosterone system inhibitorsIncident heart failureAdverse cardiovascular outcomesClinical practice guidelinesRisk of mortalityLevel of evidenceYounger women veteransHF medicationsMultiple pharmacotherapiesAntiplatelet therapyCardiovascular outcomesYounger average ageArtery diseaseCVD careGuideline recommendationsSystem inhibitorsAdverse outcomesMilitary 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 impact
2021
Sex 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 accuracyMilitary sexual trauma and suicidal ideation in VHA-care-seeking OEF/OIF/OND veterans without mental health diagnosis or treatment
Decker SE, Ramsey CM, Ronzitti S, Kerns RD, Driscoll MA, Dziura J, Skanderson M, Bathulapalli H, Brandt CA, Haskell SG, Goulet JL. Military sexual trauma and suicidal ideation in VHA-care-seeking OEF/OIF/OND veterans without mental health diagnosis or treatment. Psychiatry Research 2021, 303: 114089. PMID: 34247061, DOI: 10.1016/j.psychres.2021.114089.Peer-Reviewed Original ResearchConceptsMental health diagnosesMilitary sexual traumaVeterans Healthcare AdministrationSuicidal ideationHealth diagnosisSexual traumaRelative risk estimatesOEF/OIF/OND veteransSample of veteransPost-9/11 veteransSuicide risk factorsMental health concernsClinical remindersRisk factorsRelative riskHigh riskMen veteransMental healthcareHealth concernRisk estimatesMST survivorsWomenDiagnosisTraumaVeteransBaseline Characteristics from the Women Veterans Cohort Study: Gender Differences and Similarities in Health and Healthcare Utilization
Gaffey AE, Burg MM, Rosman L, Portnoy GA, Brandt CA, Cavanagh CE, Skanderson M, Dziura J, Mattocks KM, Bastian LA, Haskell SG. Baseline Characteristics from the Women Veterans Cohort Study: Gender Differences and Similarities in Health and Healthcare Utilization. Journal Of Women's Health 2021, 30: 944-955. PMID: 33439756, PMCID: PMC8290312, DOI: 10.1089/jwh.2020.8732.Peer-Reviewed Original ResearchConceptsWomen Veterans Cohort StudyCardiovascular risk factorsVeterans Health AdministrationRisk factorsHealthcare utilizationWomen veteransCohort studyHealth outcomesNontraditional cardiovascular risk factorsTraditional cardiovascular risk factorsUnique healthcareMental healthSingle-site painVHA healthcare systemVHA medical centersVeterans Affairs (VA) careHealth risk factorsOutside health servicesPosttraumatic stress disorder (PTSD) symptomsMultisite painBaseline characteristicsPsychosocial comorbiditiesChronic painCardiovascular diseaseMedical Center
2020
Posttraumatic Stress Disorder, Antidepressant Use, and Hemorrhagic Stroke in Young Men and Women
Gaffey AE, Rosman L, Burg MM, Haskell SG, Brandt CA, Skanderson M, Dziura J, Sico JJ. Posttraumatic Stress Disorder, Antidepressant Use, and Hemorrhagic Stroke in Young Men and Women. Stroke 2020, 52: 121-129. PMID: 33297868, PMCID: PMC7770089, DOI: 10.1161/strokeaha.120.030379.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderHemorrhagic strokeHealth care utilizationUse of SSRIsGreater riskSSRI useStroke riskCare utilizationStress disorderEffects of PTSDIncident hemorrhagic strokeMiddle-aged veteransModifiable risk factorsNon-pharmacological treatmentMultivariate Cox modelNorepinephrine reuptake inhibitorsOverall incidence rateHemorrhagic stroke riskSNRI useIncident strokeAntidepressant useReuptake inhibitorsComorbid conditionsLifestyle factorsPsychiatric comorbidityAll-cause mortality among males living with and without HIV initiating long-term opioid therapy, and its association with opioid dose, opioid interruption and other factors
Gordon K, Manhapra A, Crystal S, Dziura J, Edelman E, Skanderson M, Kerns R, Justice A, Tate J, Becker W. All-cause mortality among males living with and without HIV initiating long-term opioid therapy, and its association with opioid dose, opioid interruption and other factors. Drug And Alcohol Dependence 2020, 216: 108291. PMID: 33011662, PMCID: PMC7644145, DOI: 10.1016/j.drugalcdep.2020.108291.Peer-Reviewed Original ResearchConceptsMorphine equivalent daily doseCause mortalityLong-term opioid therapyTime-updated Cox regressionStrong dose-response relationshipUnnatural deathsEquivalent daily doseDose-response relationshipOpioid doseOpioid therapyUninfected patientsOpioid useDaily doseCox regressionMortality outcomesTherapy doseHigh doseMale veteransOverdose fatalitiesOverdose mortalityPLWHMortalityHIVPatientsDoseIncident Musculoskeletal Conditions Among Men and Women Veterans Returning From Deployment
Haskell SG, Brandt C, Bastian L, Driscoll M, Bathulapalli H, Dziura J. Incident Musculoskeletal Conditions Among Men and Women Veterans Returning From Deployment. Medical Care 2020, 58: 1082-1090. PMID: 32925458, DOI: 10.1097/mlr.0000000000001403.Peer-Reviewed Original ResearchConceptsMSK conditionsAnkle/footVeterans AffairsUpper extremityMen veteransClinical Modification diagnostic codesPercent of womenOperation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn VeteransMSK diagnosesCohort studyNinth RevisionUnadjusted ratesMusculoskeletal conditionsDiagnostic codesIncidence rateOperation New Dawn veteransFirst visitMusculoskeletal injuriesNew Dawn veteransInternational ClassificationWomen veteransLast deploymentWomenVeteransMenAssociation 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
Trauma and Sexual Risk: Do Men and Women Veterans Differ?
Combellick JL, Dziura J, Portnoy GA, Mattocks KM, Brandt CA, Haskell SG. Trauma and Sexual Risk: Do Men and Women Veterans Differ? Women's Health Issues 2019, 29: s74-s82. PMID: 31253246, DOI: 10.1016/j.whi.2019.04.014.Peer-Reviewed Original ResearchMeSH KeywordsAdultAdult Survivors of Child AbuseAgedBullyingChildCohort StudiesCrime VictimsFemaleHumansIntimate Partner ViolenceMaleMiddle AgedMilitary PersonnelRisk FactorsRisk-TakingSexual BehaviorSurveys and QuestionnairesUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthConceptsRisky sexual behaviorWomen veteransSexual behaviorSingle significant risk factorSignificant risk factorsWomen Veterans Cohort StudyVeterans Health AdministrationHistory of traumaRelated health outcomesCohort studyPredictive factorsRisk factorsMilitary-related traumaBinge drinkingMen veteransMilitary exposureHealth AdministrationHealth outcomesTrauma-related experiencesHealth servicesMultivariate analysisProtective factorsSexual riskTraumaAdditional risk
2017
Incident Cardiovascular Risk Factors Among Men and Women Veterans After Return From Deployment
Haskell SG, Brandt C, Burg M, Bastian L, Driscoll M, Goulet J, Mattocks K, Dziura J. Incident Cardiovascular Risk Factors Among Men and Women Veterans After Return From Deployment. Medical Care 2017, 55: 948-955. PMID: 28984707, DOI: 10.1097/mlr.0000000000000801.Peer-Reviewed Original ResearchConceptsCardiovascular risk factorsCV risk factorsRisk factorsImpact of sexWomen veteransClinical Modification diagnostic codesIncident cardiovascular risk factorsPrimary care visitsCoronary artery diseaseElectronic health record dataRisk of obesityVeterans Health AdministrationIncident risk factorsHealth record dataMental health conditionsBlack womenNew International ClassificationCare visitsCohort studyArtery diseaseFemale sexDiagnostic codesIncidence rateProtective effectInternational ClassificationRisk for Incident Hypertension Associated With Posttraumatic Stress Disorder in Military Veterans and the Effect of Posttraumatic Stress Disorder Treatment
Burg MM, Brandt C, Buta E, Schwartz J, Bathulapalli H, Dziura J, Edmondson DE, Haskell S. Risk for Incident Hypertension Associated With Posttraumatic Stress Disorder in Military Veterans and the Effect of Posttraumatic Stress Disorder Treatment. Psychosomatic Medicine 2017, 79: 181-188. PMID: 27490852, PMCID: PMC5285494, DOI: 10.1097/psy.0000000000000376.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderPosttraumatic stress disorder (PTSD) treatmentHypertension riskHazard ratioDisorder treatmentSelective serotonin reuptake inhibitor medicationsSerotonin reuptake inhibitor medicationsStress disorderIncident hypertension riskClinic blood pressureCardiovascular mortality riskInteraction of PTSDReuptake inhibitor medicationsLong-term health impactsStress disorder diagnosisPosttraumatic stress disorder (PTSD) diagnosisAntihypertensive medicationsHypertension AssociatedIncident hypertensionHypertensive rangeBlood pressureInhibitor medicationMedical visitsCardiovascular diseaseMortality risk
2016
Incidence of Mental Health Diagnoses in Veterans of Operations Iraqi Freedom, Enduring Freedom, and New Dawn, 2001-2014.
Ramsey C, Dziura J, Justice AC, Altalib HH, Bathulapalli H, Burg M, Decker S, Driscoll M, Goulet J, Haskell S, Kulas J, Wang KH, Mattocks K, Brandt C. Incidence of Mental Health Diagnoses in Veterans of Operations Iraqi Freedom, Enduring Freedom, and New Dawn, 2001-2014. American Journal Of Public Health 2016, 107: 329-335. PMID: 27997229, PMCID: PMC5227942, DOI: 10.2105/ajph.2016.303574.Peer-Reviewed Original ResearchConceptsMental health diagnosesMajor depressive disorderPosttraumatic stress disorderHealth diagnosisIncidence rateDrug use disorder diagnosisIncident posttraumatic stress disorderOperation Iraqi FreedomAge 18Veterans Health Administration electronic health recordsDisorder diagnosisIncident bipolar disorderHigh-risk groupSociodemographic risk factorsAlcohol use disorder diagnosisMental health conditionsEnduring FreedomIraqi FreedomRace/ethnicityElectronic health recordsIncident schizophreniaRisk factorsDepressive disorderAge 45MDD diagnosisIncrease in migraine diagnoses and guideline-concordant treatment in veterans, 2004–2012
Altalib H, Fenton B, Sico J, Goulet J, Bathulapalli H, Mohammad A, Kulas J, Driscoll M, Dziura J, Mattocks K, Kerns R, Brandt C, Haskell S. Increase in migraine diagnoses and guideline-concordant treatment in veterans, 2004–2012. Cephalalgia 2016, 37: 3-10. PMID: 26950804, DOI: 10.1177/0333102416631959.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnalgesicsFemaleGuideline AdherenceHumansMaleMiddle AgedMigraine DisordersVeteransConceptsBurden of migraineMigraine diagnosisVeterans Health Administration electronic health recordsGuideline-concordant treatmentGuideline-concordant careMigraine-specific medicationsICD-9 codesChi-square testHealth care systemNumber of veteransElectronic health recordsTriptan prescriptionMigraine preventionGuideline adherenceMigraine medicationsComorbid conditionsNational health care systemMigraine headacheMedicationsMigraineTime-series studyLogistic regressionCare systemPreventive medicineHealth administrators
2015
Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV
Becker WC, Gordon K, Jennifer Edelman E, Kerns RD, Crystal S, Dziura JD, Fiellin LE, Gordon AJ, Goulet JL, Justice AC, Fiellin DA. Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV. AIDS And Behavior 2015, 20: 679-686. PMID: 26384973, PMCID: PMC5006945, DOI: 10.1007/s10461-015-1197-5.Peer-Reviewed Original Research