VA Medical Article Discusses Specialized Iraq and Afghanistan Veteran Health Care Needs

Review by VA Clinicians Assists Health Care Providers

WASHINGTON – Department of Veterans Affairs clinicians offer a comprehensive review of the health concerns of Iraq and Afghanistan Veterans and practical management guidelines for primary care providers in an article entitled Post Deployment Care for Returning Combat Veterans, and published in Journal of General Internal Medicine (JGIM). 

“We at VA are always seeking ways to improve the quality of health care we provide to our Veterans,” said Secretary of Veterans Affairs Eric K. Shinseki.  “This article provides valuable insight into the fastest-growing segment of the Veteran population at a time they are currently returning from combat.”   

Since September 11, 2001, approximately 2.4 million military personnel have deployed to Iraq and Afghanistan.   The health care needs of this particular patient population are complex, and require a well integrated interdisciplinary approach to care.

The article, written by Juliette F. Spelman, MD; Stephen C. Hunt, MD, MPH; Karen H. Seal, MD, MPH; and Lucile Burgo-Black, MD, reviews how combat deployments can impact the physical, psychological, and social health of Veterans and describes their unique health care needs. This includes the need for assessment and management of injuries associated with blast exposures (including mild traumatic brain injury) as well as mental health conditions such as posttraumatic stress disorder, depression, and substance abuse.

Other important health concerns discussed include chronic musculoskeletal pain, medically unexplained symptoms, complications from environmental exposures, heightened suicide risk, sleep disturbances, and impairments in family, occupational and social functioning.

The article summarizes evidence which supports elevated frequencies of physiological and behavioral cardiovascular risk factors, including hypertension and tobacco use, raising concerns about future health implications for these Veterans. In light of relationships between physical, psychological and psychosocial concerns in this population, the VA authors recommend an interdisciplinary approach to care directed toward mitigating the long-term health impacts of combat. 

            This comprehensive review by VA clinicians will help both VA and non-VA health providers offer Veterans the best possible care as they return from combat deployments.  It affords all involved the opportunity to develop greater collaboration between VA and community providers to insure optimal post-deployment care and services for our returning combat Veterans and their families.

Each VA medical center has a highly specialized Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) Care Management team in place that coordinates and oversees transition and care for OEF/OIF/OND Servicemembers and Veterans.  A dedicated case manager is assigned to work with the Servicemember/Veteran and family to screen for case management needs and implement a plan of care to completion, or as long as needed.

JGIM is the official journal of the Society of General Internal Medicine.  It promotes improved patient care, research, and education in primary care, general internal medicine, and hospital medicine.  Its articles focus on clinical medicine, epidemiology, prevention, health care delivery, curriculum development, and some non-traditional themes.  JGIM offers early publication on www.SpringerLink.com to reach a broad audience, with online access to abstracts and full articles rapidly growing each year.  Learn more about JGIM at www.sgim.org/go/jgim.

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