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Insomnia and Insomnia-Related Care in the Department of Veterans Affairs: An Electronic Health Record Analysis

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 201...

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Autores principales: Bramoweth, Adam D., Tighe, Caitlan A., Berlin, Gregory S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8394102/
https://www.ncbi.nlm.nih.gov/pubmed/34444321
http://dx.doi.org/10.3390/ijerph18168573
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author Bramoweth, Adam D.
Tighe, Caitlan A.
Berlin, Gregory S.
author_facet Bramoweth, Adam D.
Tighe, Caitlan A.
Berlin, Gregory S.
author_sort Bramoweth, Adam D.
collection PubMed
description 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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spelling pubmed-83941022021-08-28 Insomnia and Insomnia-Related Care in the Department of Veterans Affairs: An Electronic Health Record Analysis Bramoweth, Adam D. Tighe, Caitlan A. Berlin, Gregory S. Int J Environ Res Public Health Article 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. MDPI 2021-08-13 /pmc/articles/PMC8394102/ /pubmed/34444321 http://dx.doi.org/10.3390/ijerph18168573 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bramoweth, Adam D.
Tighe, Caitlan A.
Berlin, Gregory S.
Insomnia and Insomnia-Related Care in the Department of Veterans Affairs: An Electronic Health Record Analysis
title Insomnia and Insomnia-Related Care in the Department of Veterans Affairs: An Electronic Health Record Analysis
title_full Insomnia and Insomnia-Related Care in the Department of Veterans Affairs: An Electronic Health Record Analysis
title_fullStr Insomnia and Insomnia-Related Care in the Department of Veterans Affairs: An Electronic Health Record Analysis
title_full_unstemmed Insomnia and Insomnia-Related Care in the Department of Veterans Affairs: An Electronic Health Record Analysis
title_short Insomnia and Insomnia-Related Care in the Department of Veterans Affairs: An Electronic Health Record Analysis
title_sort insomnia and insomnia-related care in the department of veterans affairs: an electronic health record analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8394102/
https://www.ncbi.nlm.nih.gov/pubmed/34444321
http://dx.doi.org/10.3390/ijerph18168573
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