Voices of VA Research Podcast

Mitch Mirkin of VA Research Communications interviews Dr. Cari Levy, chief of palliative care at the Denver VA Medical Center and associate director of the Center of Innovation for Veteran-Centered and Value-Driven Research. Levy talks about the concept of the VA medical foster home, and explains what her studies have shown regarding this innovative model of long-term care for Veterans. VA medical foster homes are private family homes in which trained caregivers provides 24/7 services to no more than three individuals. The homes go through a rigorous inspection and approval process.

Read more: No place like home

Mike Richman of VA Research Communications interviews Dr. Samir Gupta, chief of gastroenterology at the VA San Diego Healthcare System. He’s leading the VA Colonoscopy Collaborative, which is aiming to provide a framework for maximizing VA’s effectiveness with colonoscopy and to ultimately improve health outcomes for Veterans. Colonoscopy has long been considered a good screening method for the early detection of colon cancer, the second-leading cause of cancer deaths in the United States. Colon cancer is also one of the most preventable forms of cancer, but making sure that Veterans are getting proper colon cancer screening is critical.

Mike Richman of VA Research Communications interviews Dr. Sara Knight of the VA Salt Lake City Health Care System. She’s leading a study that is exploring the return of genetic results to research participants, an area of genomic medicine that’s the topic of much debate. Her study aims to find out if Vets want their genetic results returned, why they’d want them returned, and what details they’d want to see and under what circumstances. Currently, VA’s Million Veteran Program is the agency’s most ambitious genomic initiative, but the MVP program doesn’t return genetic results to enrollees.

Mitch Mirkin of VA Research Communications interviews Dr. Ann Elizabeth Montgomery of VA’s National Center on Homelessness Among Veterans. Montgomery recently led a study titled “Veterans’ Assignment to Single-Site Versus Scattered-Site Permanent Supportive Housing.” The conversation focused on the HUD-VASH program and the types of living situations it offers Veterans.

Read more: Housing for homeless Veterans

Mike Richman of VA Research Communications interviews Dr. Sarah Hartz, a psychiatrist at the VA Eastern Kansas Health Care System. Hartz led a study that found that consuming alcoholic beverages daily—even at low levels that meet U.S. guidelines for safe drinking—appears to be “detrimental” to your health. The researchers found that downing one to two drinks at least four days per week was tied to a 20 percent increase in the risk of premature death, compared with drinking three times a week or less. The study is one of a series of recent research papers that have challenged the theory that alcohol has health benefits.

Mike Richman of VA Research Communications interviews Dr. Robert Shura, neuropsychologist at the W.G. (Bill) Hefner VA Medical Center in North Carolina. Shura led a study that found that Iraq and Afghanistan Veterans with a history of multiple traumatic brain injuries—versus none—are at much greater risk for considering suicide. The study said Veterans in this cohort are about twice as likely to report recent suicidal ideation, which the study defines as suicidal thoughts over the past week—compared with Vets with one TBI or none at all. Traumatic brain injury is the signature injury from the wars in Iraq and Afghanistan. Suicide prevention is VA’s top clinical priority).

Mitch Mirkin of VA Research Communications interviews Drs. Lori Davis and J. Douglas Bremner about their research into mindfulness as a tool to help Veterans with PTSD. Davis is the associate chief of staff for research at the VA Medical Center in Tuscaloosa, Alabama. She's also a professor at the University of Alabama Health System in both Tuscaloosa and Birmingham. Bremner is the director of mental health research at the Atlanta VA Medical Center, and a professor at the Emory Clinical Neuroscience Research Unit at Emory University School of Medicine. Dr. Bremner is also the author of several books, some of which deal with the risks of prescription drugs.

Read more: Mindfulness and PTSD: What does the research show?

Mike Richman of VA Research Communications interviews Dr. Jason Vassy, a clinician and researcher at the VA Boston Healthcare System. Vassy is leading a study that is focusing on whether a test for a specific gene can help patients and doctors choose the right type and dose of statin drugs, which are often used by people with high cholesterol, a risk factor for heart attack, heart disease, and stroke. Statins have been shown to help lower harmful cholesterol levels. Vassy is eager to learn whether pharmacogenetics can help in choosing the right statin medication. The relatively new field of medicine examines how a patient’s genetic make-up affects how he or she responds to a particular drug.

Read more: It's in the genes

Mike Richman of VA Research Communications interviews Dr. Barbara Niles, a research psychologist in the National Center for PTSD at the VA Boston Healthcare System. Niles is leading a trial that is examining whether tai chi, an ancient Chinese mind-body therapy, can help ease the chronic pain and fatigue symptoms that are common among Veterans with Gulf War illness. Most of the treatments have been pharmaceutical. Tai chi is a graceful form of exercise that improves balance and coordination skills, with slow and deliberate balletic body movements.

Read more: Meditation in motion

Erica Sprey of VA Research Communications speaks with Dr. Walid Gellad, a primary care physician and health services researcher at the VA Pittsburgh Healthcare System. Dr. Gellad's research is broadly focused on improving the delivery of health care services, and more specifically, improving Veterans' access to safe and appropriate prescription medications.

Gellad and his colleagues published a study in the American Journal of Public Health that described the number of Veterans who receive opioid medications both through VA and Medicare Part D. The concern is that Veterans who use both systems may be getting potentially unsafe doses of opioids. Gellad says there is a danger that Veterans who are "dual users" will receive higher doses of opioids because of fragmentation of care and lack of communication between VA and community providers.

"VA has done a tremendous amount to address prescription opioid use among Veterans to improve safety," he says. "All of that effort has focused within VA, because that is what they are measuring. There is still not an easy way to nationally measure opioids that Veterans might be getting outside the VA."

Read more: 'Dual use' Veterans may be at risk for unsafe opioid use