Insomnia and Insomnia-Related Care in the Department of Veterans Affairs: An Electronic Health Record Analysis.
Insomnia and Insomnia-Related Care in the Department of Veterans Affairs: An Electronic Health Record Analysis.
复制标题
退伍军人事务部的失眠和失眠有关的护理：电子健康记录分析。
DOI：
10.3390/ijerph18168573
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发表时间：
2021-08-13
影响因子：
--
通讯作者：
Berlin GS
中科院分区：
文献类型：
--
作者：
Bramoweth AD;Tighe CA;Berlin GS
目的是检查自2011年退伍军人事务部（VA）推出失眠认知行为疗法（CBT-I）以来，退伍军人事务部（VA）设施区域网络内的失眠和失眠相关护理情况。对2011年至2019年VA电子健康记录（EHR）数据进行回顾性分析。测量了四项失眠指标的年度和总体患病率：诊断、药物、评估/治疗咨询和参与CBT-I。此外，还研究了有和没有失眠指标的退伍军人之间的社会人口学和临床差异，以及四种个体失眠指标之间的差异。样本包括439,887名退伍军人，其中17%被四项指标中的一项所识别；药物治疗是最常见的（15%），其次是诊断（6%）、咨询（1.5%）和CBT-I（0.6%）。随着时间的推移，趋势包括每年诊断、咨询和CBT-I的比率增加，药物治疗的比率下降。社会人口学和临床变量之间的指标存在显著差异。一项对大量退伍军人样本的评估表明，处方睡眠药物仍然是识别失眠症退伍军人的最佳方法。此外，根据退伍军人事务部电子病历数据，失眠症的诊断仍然不足，这可能对符合临床实践指南的治疗产生影响，并可能对退伍军人的健康产生负面影响。
The objective was to examine insomnia and insomnia-related care within a regional network of Department of Veterans Affairs (VA) facilities since the VA roll-out of cognitive behavioral therapy for insomnia (CBT-I) in 2011. A retrospective analysis of VA electronic health records (EHR) data from 2011 to 2019 was conducted. The annual and overall prevalence of four insomnia indicators was measured: diagnoses, medications, consultations for assessment/treatment, and participation in CBT-I. Also examined were sociodemographic and clinical differences among veterans with and without an insomnia indicator, as well as differences among the four individual insomnia indicators. The sample included 439,887 veterans, with 17% identified by one of the four indicators; medications was most common (15%), followed by diagnoses (6%), consults (1.5%), and CBT-I (0.6%). Trends over time included increasing yearly rates for diagnoses, consults, and CBT-I, and decreasing rates for medications. Significant differences were identified between the sociodemographic and clinical variables across indicators. An evaluation of a large sample of veterans identified that prescription sleep medications remain the best way to identify veterans with insomnia. Furthermore, insomnia continues to be under-diagnosed, per VA EHR data, which may have implications for treatment consistent with clinical practice guidelines and may negatively impact veteran health.
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影响因子：
1.6
作者：
Bramoweth, Adam D.;Luther, James;Germain, Anne
通讯作者：
Germain, Anne
影响因子：
4.1
作者：
Trockel, Mickey;Karlin, Bradley E.;Manber, Rachel
通讯作者：
Manber, Rachel
影响因子：
39
作者：
Wu, Jade Q.;Appleman, Erica R.;Ong, Jason C.
通讯作者：
Ong, Jason C.
影响因子：
7
作者：
DiNapoli, Elizabeth A.;Bramoweth, Adam D.;Kasckow, John
通讯作者：
Kasckow, John
DOI：
10.1037/tra0000428
发表时间：
2019-11-01
影响因子：
6.3
作者：
Valenstein-Mah, Helen;Kehle-Forbe, Shannon;Spoont, Michele
通讯作者：
Spoont, Michele