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Military Health System Studies Inventory Tool

Welcome to the Military Health System Studies Inventory Tool (MSIT). Military Health System (MHS) data are used by Department of Defense, Veterans Administration, and academic health professionals and scientists to implement health care studies. These studies reflect the MHS interest to rigorously assess and improve our beneficiaries’ access to the high quality health care services they need. Additionally, these studies are frequently used to develop or improve MHS policy and often adopt useful, relevant comparisons to the national health care experience.

The MSIT allows easy review of recent studies that are either conducted or sponsored by the MHS, or accomplished using datasets developed or maintained by the Defense Health Agency for administrative, operational, or research purposes. The studies within this website represent important contributions of the MHS to the national health care dialogue and reflect our capacity to tackle the challenging issues needed to support evidence-informed health policy. Thank you for your interest in them.

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Energy drink and energy shot use in the military.

Study

Abstract

Use of energy drinks and energy shots among military personnel is controversial. High amounts of caffeine (the primary active ingredient in these products) may impact performance of military duties. The impact of caffeine overconsumption and potential subsequent side effects that might be experienced by service members with unique roles and responsibilities is a concern. Reported here are the prevalence of use, reasons for use, and side effects associated with consumption of energy drinks and energy shots among several populations of active duty personnel in the US military. A snowball survey was sent to over 10,000 active duty personnel. A total of 586 (∼6% response rate) individuals completed a 30-item electronic survey. Over half of respondents (53%) reported consuming an energy drink at least once in the past 30 days. One in five (19%) reported energy shot consumption in the prior 30 days. One in five (19%) also reported consuming an energy drink in combination with an alcoholic beverage. Age and gender were significantly associated with energy drink consumption. Young male respondents (18-29 years) reported the highest use of both energy drinks and energy shots. Among those reporting energy drink and energy shot use, the most common reasons for consumption were to improve mental alertness (61%) and to improve mental (29%) and physical (20%) endurance. Nearly two-thirds (65%) of users self-reported at least one side effect. The most commonly reported side effects included increased pulse rate/palpitations, restlessness, and difficulty sleeping. Use of energy products among military personnel is common and has the potential to impact warrior health and military readiness.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Uniformed Services University of Health Sciences
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: October 01, 2014
  • Citation: Stephens MB, Attipoe S, Jones D, Ledford CJ, Deuster PA. Energy drink and energy shot use in the military. Nutr Rev. 2014 Oct;72 Suppl 1:72-7.

Influence of the severity and location of bodily injuries on post-concussive and combat stress symptom reporting after military-related concurrent mild traumatic brain injuries and polytrauma.

Study

Abstract

Traumatic brain injuries (TBI) sustained in combat frequently co-occur with significant bodily injuries. Intuitively, more extensive bodily injuries might be associated with increased symptom reporting. In 2012, however, French et al. demonstrated an inverse relation between bodily injury severity and symptom reporting. This study expands on that work by examining the influence of location and severity of bodily injuries on symptom reporting after mild TBI. Participants were 579 US military service members who sustained an uncomplicated mild TBI with concurrent bodily injuries and who were evaluated at two military medical centers. Bodily injury severity was quantified using a modified Injury Severity Score (ISSmod). Participants completed the Neurobehavioral Symptom Inventory (NSI) and the Posttraumatic Stress Disorder Checklist (PCL-C), on average, 2.5 months post-injury. There was a significant negative association between ISSmod scores and NSI (r=-0.267, p<0.001) and PCL-C (r=-0.273, p<0.001) total scores. Using linear regression to examine the relation between symptom reporting and injury severity across the six ISS body regions, three body regions were significant predictors of the NSI total score (face; p<0.001; abdomen; p=0.003; extremities; p<0.001) and accounted for 9.3% of the variance (p<0.001). For the PCL-C, two body regions were significant predictors of the PCL-C total score (face; p<0.001; extremities; p<0.001) and accounted for 10.5% of the variance. There was an inverse relation between bodily injury severity and symptom reporting in this sample. Hypothesized explanations include underreporting of symptoms, increased peer support, disruption of fear conditioning because of acute morphine use, or delayed expression of symptoms.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense and Veterans Brain Injury Center
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: October 01, 2014
  • Citation: French LM, et.al . Influence of the severity and location of bodily injuries on post-concussive and combat stress symptom reporting after military-related concurrent mild traumatic brain injuries and polytrauma. J Neurotrauma. 2014 Oct 1;31(19):1607-16.

The Millennium Cohort Family Study: a prospective evaluation of the health and well-being of military service members and their families.

Study

Abstract

The need to understand the impact of war on military families has never been greater than during the past decade, with more than three million military spouses and children affected by deployments to Operations Iraqi Freedom and Enduring Freedom. Understanding the impact of the recent conflicts on families is a national priority, however, most studies have examined spouses and children individually, rather than concurrently as families. The Department of Defense (DoD) has recently initiated the largest study of military families in US military history (the Millennium Cohort Family Study), which includes dyads of military service members and their spouses (n > 10,000). This study includes US military families across the globe with planned follow-up for 21+ years to evaluate the impact of military experiences on families, including both during and after military service time. This review provides a comprehensive description of this landmark study including details on the research objectives, methodology, survey instrument, ancillary data sets, and analytic plans. The Millennium Cohort Family Study offers a unique opportunity to define the challenges that military families experience, and to advance the understanding of protective and vulnerability factors for designing training and treatment programs that will benefit military families today and into the future.

  • Publication Status: Published
  • Sponsoring Organization: Navy
  • Sponsoring Office:
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: October 01, 2014
  • Citation: Crum-Cianflone NF, Fairbank JA, Marmar CR, Schlenger W. The Millennium Cohort Family Study: a prospective evaluation of the health and well-being of military service members and their families. Int J Methods Psychiatr Res. 2014 Sep;23(3):320-30.

Implementing collaborative primary care for depression and posttraumatic stress disorder: Design and sample for a randomized trial in the U.S. military health system

Study

Abstract

BACKGROUND: War-related trauma, posttraumatic stress disorder (PTSD), depression and suicide are common in US military members. Often, those affected do not seek treatment due to stigma and barriers to care. When care is sought, it often fails to meet quality standards. A randomized trial is assessing whether collaborative primary care improves quality and outcomes of PTSD and depression care in the US military health system. OBJECTIVE: Describe the design and sample for a randomized effectiveness trial of collaborative care for PTSD and depression in military members attending primary care. METHODS: The STEPS-UP Trial (Stepped Enhancement of PTSD Services Using Primary Care) is a 6 installation (18 clinic) randomized effectiveness trial in the US military health system. Study rationale, design, enrollment and sample characteristics are summarized. Findings Military members attending primary care were referred to care management with suspected PTSD, depression or both were recruited for the trial (2,592) and 1,041 gave permission to contact for research participation. Of those, 666 (64%) met eligibility criteria, completed baseline assessments, and were randomized to 12months of usual collaborative primary care versus STEPS-UP collaborative care. Implementation was locally managed for usual collaborative care and centrally managed for STEPS-UP. Research reassessments occurred at 3-, 6-, and 12-months. Baseline characteristics were similar across the two intervention groups. CONCLUSIONS: STEPS-UP will be the first large scale randomized effectiveness trial completed in the US military health system, assessing how an implementation model affects collaborative care impact on mental health outcomes. It promises lessons for health system change.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Uniformed Services University of Health Sciences
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: October 01, 2014
  • Citation: Engel CC, et.al. Implementing collaborative primary care for depression and posttraumatic stress disorder: Design and sample for a randomized trial in the U.S. military health system. Contemp Clin Trials. 2014 Oct 10

Use and Abuse of Prescribed Opioids, Central Nervous System Depressants, and Stimulants Among U.S. Active Duty Military Personnel in FY 2010

Study

Abstract

OBJECTIVES: This study establishes rates of use/abuse of Schedule II-IV prescription medications in U.S. active duty military personnel, and characterizes correlates of such use/abuse. METHODS: All active duty personnel serving for 12 months during fiscal year 2010 were included. Data were obtained from medical and pharmacy claims and drug screening results. Logistic regression models were used to examine predictors of drug use, along with bivariate analyses to compare abuse of prescribed and illegal drugs. RESULTS: Nearly one-third of active duty service members received at least one prescription for opioids, central nervous system depressants, or stimulants, with 26.4% having received at least one prescription for opioids. About 0.7%, 1.4%, and 0.6% of the total force received >90-day prescriptions for opioids, central nervous system depressants, or stimulants, respectively. Battlefield injury, receipt of psychotropic medications, and substance abuse adverse events were predictive of >90-day supply of opioids. About 0.7% of the total force had documented known drug abuse for prescribed drugs compared to 0.4% for illegal drug abuse. CONCLUSIONS: We recommend systematic monitoring of prescriptions for controlled substances which may carry serious consequences, evaluation of the impact of controlled substances on military readiness, and examination of the rationale for prescribing controlled drugs.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense Health Agency (formerly TRICARE Management Activity)
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: October 01, 2014
  • Citation: Jeffery DD, May L, Luckey B, Balison BM, Klette KL. Use and Abuse of Prescribed Opioids, Central Nervous System Depressants, and Stimulants Among U.S. Active Duty Military Personnel in FY 2010. Mil Med. 2014 Oct;179(10):1141-8

Female military medical school graduates entering surgical internships: are we keeping up with national trends?

Study

Abstract

BACKGROUND: Ratios of women graduating from the only US military medical school and entering surgical internships were reviewed and compared with national trends. METHODS: Data were obtained from the Uniformed Services University of the Health Sciences graduation announcements from 2002 to 2012. RESULTS: There were 1,771 graduates from 2002 to 2012, with 508 female (29%) and 1,263 male (71%) graduates. Female graduates increased over time (21% to 39%; P = .014). Female general surgery interns increased from 3.9% to 39% (P = .025). Female overall surgical subspecialty interns increased from 20% in 2002 to 36% in 2012 (P = .046). Women were represented well in obstetrics (57%), urology (44%), and otolaryngology (31%), but not in neurosurgery, orthopedics, and ophthalmology (0% to 20%). CONCLUSIONS: The sex disparity between military and civilian medical students occurs before entry. Once in medical school, women are just as likely to enter general surgery or surgical subspecialty as their male counterparts. Increased ratio of women in the class is unlikely to lead to a shortfall except in specific subspecialties.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Walter Reed National Military Medical Center/Uniformed Services University of Health Sciences
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: October 01, 2014
  • Citation: Vertrees A, Laferriere N, Elster E, Shriver CD, Rich NM. Female military medical school graduates entering surgical internships: are we keeping up with national trends? Am J Surg. 2014 Oct;208(4):550-5.

A Multisite Study of the Relationships between Blast Exposures and Symptom Reporting in a Post-Deployment Active Duty Military Population with Mild Traumatic Brain Injury

Study

Abstract

Explosive devices have been the most frequent cause of traumatic brain injury (TBI) among deployed contemporary U.S. service members. The purpose of this study was to examine the influence of previous cumulative blast exposures (that did or did not result in TBI) on later post-concussion and post-traumatic symptom reporting after sustaining a mild TBI (MTBI). Participants were 573 service members who sustained MTBI divided into four groups by number of blast exposures (1, 2, 3, and 4-10) and a nonblast control group. Post-concussion symptoms were measured using the Neurobehavioral Symptom Inventory (NSI) and post-traumatic stress disorder (PTSD) symptoms using the Post-traumatic Checklist-Civilian version (PCL-C). Results show groups significantly differed on total NSI scores (p<0.001), where symptom endorsement increased as number of reported blast exposures increased. Total NSI scores were significantly higher for the 3- and 4-10 blast groups compared with the 1- and 2-blast groups with effect sizes ranging from small to moderate (d=0.31 to 0.63). After controlling for PTSD symptoms using the PCL-C total score, NSI total score differences remained between the 4-10-blast group and the 1- and 2-blast groups, but were less pronounced (d=0.35 and d=0.24, respectively). Analyses of NSI subscale scores using PCL-C scores as a covariate revealed significant between-blast group differences on cognitive, sensory, and somatic, but not affective symptoms. Regression analyses revealed that cumulative blast exposures accounted for a small but significant amount of the variance in total NSI scores (4.8%; p=0.009) and total PCL-C scores (2.3%; p<0.001). Among service members exposed to blast, post-concussion symptom reporting increased as a function of cumulative blast exposures. Future research will need to determine the relationship between cumulative blast exposures, symptom reporting, and neuropathological changes

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense and Veterans Brain Injury Center
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: October 01, 2014
  • Citation: Reid MW, et.al., A Multisite Study of the Relationships between Blast Exposures and Symptom Reporting in a Post-Deployment Active Duty Military Population with Mild Traumatic Brain Injury. J Neurotrauma. 2014 Dec 1;31(23):1899-906.

Prevalence, health care utilization, and costs of fibromyalgia, irritable bowel, and chronic fatigue syndromes in the military health system, 2006-2010.

Study

Abstract

OBJECTIVE: We compared prevalence, health care utilization, and costs over time for nonelderly adults diagnosed with fibromyalgia syndrome (FMS), irritable bowel syndrome (IBS), and chronic fatigue syndrome (CFS) in relation to timing of federal approvals for FMS drugs. DATA SOURCE: We used military health care claims from October 2006 to September 2010. STUDY DESIGN/ANALYSIS: Retrospective, multiple-year comparisons were conducted using trend analyses, and time series regression-based generalized linear models. RESULTS: Over 5 years, FMS prevalence rates increased from 0.307% to 0.522%, whereas IBS and CFS prevalence rates remained stable. The largest increase in FMS prevalence occurred between 2007 and 2008. Health care utilization was higher for FMS cases compared to IBS and CFS cases. Over 5 years, the total cost for FMS-related care increased $163.2 million, whereas IBS costs increased $14.9 million and CFS cost increased $3.7 million. Between 2006 and 2010, total pharmacy cost for FMS cases increased from $55 million ($3,641/person) to $96.3 million ($3,557/person). CONCLUSION: Although cause and effect cannot be established, the advent of federally approved drugs for FMS in concert with pharmaceutical industry marketing of these drugs coincide with the observed changes in prevalence, health care utilization, and costs of FMS relative to IBS and CFS.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense Health Agency (formerly TRICARE Management Activity)
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: September 01, 2014
  • Citation: Jeffery DD, Bulathsinhala L, Kroc M, Dorris J. Prevalence, health care utilization, and costs of fibromyalgia, irritable bowel, and chronic fatigue syndromes in the military health system, 2006-2010. Mil Med. 2014 Sep;179(9):1021-9.

Day of injury cognitive performance on the Military Acute Concussion Evaluation (MACE) by U.S. military service members in OEF/OIF.

Study

Abstract

OBJECTIVES: The study investigated the clinical validity of the cognitive screening component of the Military Acute Concussion Evaluation (MACE) for the evaluation of acute mild traumatic brain injury (mTBI) in a military operational setting. METHODS: This was a retrospective data study involving analysis of MACE data on Operation Enduring Freedom/Operation Iraqi Freedom deployed service members with mTBI. In total, 179 cases were included in analyses based on ICD-9 diagnostic codes and characteristics of mTBI, and availability of MACE data on day of injury. MACE data from the mTBI group was compared to a military sample without mTBI administered the MACE as part of a normative data project. RESULTS: On day of injury, the mTBI group performed worse than controls on the MACE cognitive test (d = 0.90), with significant impairments in all cognitive domains assessed. MACE cognitive score was strongly associated with established indicators of acute injury severity. Lower MACE cognitive performance on day of injury was predictive of lengthier postinjury recovery time and time until return to duty after mTBI. CONCLUSIONS: Findings from the current study support the use of the MACE as a valid screening tool to assess for cognitive dysfunction in military service members during the acute phase after mTBI.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense and Veterans Brain Injury Center
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: September 01, 2014
  • Citation: McCrea M, Guskiewicz K, Doncevic S, Helmick K, Kennedy J, Boyd C, et.al., . Day of injury cognitive performance on the Military Acute Concussion Evaluation (MACE) by U.S. military service members in OEF/OIF. Mil Med. 2014 Sep;179(9):990-7.

Providing care to military personnel and their families: how we can all contribute.

Study

Abstract

Providing medical care to members of the military and their families remains a societal duty carried out not only by military physicians but also, and in large part, by civilian providers. As many military families are geographically dispersed, it is probable that all physicians at some point in their training or careers will care for this unique patient population. Understanding the military culture can help physicians provide the best care possible to our military families, and inclusion of military cultural competency curricula in all medical schools is a first step in advancing this understanding. The authors review the knowledge, skills, and attitudes that all health professionals should acquire to be able to care for those who serve and offer recommendations for developing these among all students and trainees.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Uniformed Services University of Health Sciences
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: September 01, 2014
  • Citation: Gleeson TD, Hemmer PA. Providing care to military personnel and their families: how we can all contribute. Acad Med. 2014 Sep;89(9):1201-3.

Diagnostic Utility of the Posttraumatic Stress Disorder (PTSD) Checklist for Identifying Full and Partial PTSD in Active-Duty Military.

Study

Abstract

The aim of this study was to determine optimally efficient cutoff scores on the Posttraumatic Stress Disorder Checklist (PCL) for identifying full posttraumatic stress disorder (PTSD) and partial PTSD (P-PTSD) in active-duty Marines and Sailors. Participants were 1,016 Marines and Sailors who were administered the PCL and Clinician-Administered PTSD Scale (CAPS) 3 months after returning from Operations Iraqi and Enduring Freedom. PCL cutoffs were tested against three CAPS-based classifications: full PTSD, stringent P-PTSD, and lenient P-PTSD. A PCL score of 39 was found to be optimally efficient for identifying full PTSD. Scores of 38 and 33 were found to be optimally efficient for identifying stringent and lenient P-PTSD, respectively. Findings suggest that the PCL cutoff that is optimally efficient for detecting PTSD in active-duty Marines and Sailors is substantially lower than the score of 50 commonly used by researchers. In addition, findings provide scores useful for identifying P-PTSD in returning service members.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense and Veterans Brain Injury Center
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: September 01, 2014
  • Citation: Dickstein BD, Weathers FW, Angkaw AC, Nievergelt CM, Yurgil K, Nash WP, et.al. . Diagnostic Utility of the Posttraumatic Stress Disorder (PTSD) Checklist for Identifying Full and Partial PTSD in Active-Duty Military. Assessment. 2014 Sep 1.

Opiate-related dependence/abuse and PTSD exposure among the active-component U.S. military, 2001 to 2008.

Study

Abstract

BACKGROUND: Over the past 5 years, diagnoses for opiate abuse or dependency and post-traumatic stress disorder (PTSD) have increased across all U.S. military services. Moreover, in the United States, opiate prescription dependence and abuse has now surpassed all other illicit drugs of abuse with the exception of marijuana. Some research indicates that PTSD is predictive of substance dependence and abuse, while other research suggests that substance dependence and abuse may lead to events that trigger PTSD. This dichotomy has not been extensively explored within a military population. METHODS: Using conditional multiple logistic regression analysis, a matched case-control study with 18,606 active-component U.S. military service members was conducted to examine the relationship between opiate dependence or abuse and PTSD. RESULTS: Among the 18,606 service members included in the analysis, 21% were cases and 79% were controls. Thirteen percent of service members with substance dependence or abuse diagnosis had a prior PTSD diagnosis compared to 1% of controls. After, adjusting for sociodemographic and military characteristics, the odds of having a prior diagnosis of PTSD was 28 (95% CI: 21.24-37.78) times greater for service members with opiate abuse/dependency compared to controls. CONCLUSION: These findings suggest active duty military personnel diagnosed with PTSD should be closely monitored to reduce the likelihood of future morbidity because of opiate dependence or abuse.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Armed Forces Health Surveillance Center
  • Congressionally Mandated: No
  • Funding Source: Army
  • Release Date/Publication: August 01, 2014
  • Citation: Dabbs C, Watkins EY, Fink DS, Eick-Cost A, Millikan AM. Opiate-related dependence/abuse and PTSD exposure among the active-component U.S. military, 2001 to 2008. Mil Med. 2014 Aug;179(8):885-90.

Stress and Resilience in Military Mortuary Workers: Care of the Dead From Battlefield to Home.

Study

Abstract

The death of a military service member in war provokes feelings of distress and pride in mortuary workers who process the remains. To further understand their reactions, the authors interviewed 34 military and civilian personnel to learn more about their work stresses and rewards. They review stresses of anticipation, exposure, and experience in handling the dead and explore the personal, supervisory, and leadership strategies to reduce negative effects and promote personal growth. These results can be applied to many other situations requiring planning, implementing, and supervising mortuary operations involving mass death.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Uniformed Services University of Health Sciences
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: August 01, 2014
  • Citation: Flynn BW, McCarroll JE, Biggs QM. Stress and Resilience in Military Mortuary Workers: Care of the Dead From Battlefield to Home. Death Stud. 2014 Aug 20:1-7.

Three-year outcome following moderate-to-severe TBI in U.S. military service members: a descriptive cross-sectional study.

Study

Abstract

This study examined the prospective course of neurobehavioral symptom reporting and health-related quality of life within the first 3 years following moderate-to-severe traumatic brain injury (TBI). Participants were 52 U.S. service members who were evaluated following a moderate-to-severe TBI sustained in the combat theater during Operations Iraqi and Enduring Freedom (90.4%), or from other noncombat-related incidents. Participants completed the Neurobehavioral Symptom Inventory and Post-Traumatic Stress Disorder-Checklist within 3 months postinjury, and at least one follow-up telephone interview at 12 (n = 27), 24 (n = 31), or 36 months (n = 22) postinjury. Approximately half of the sample (41.9%-63.0%) reported "persistent" symptoms from baseline to follow-up. A substantial minority also "improved" (22.2%-31.8%) or "developed" new symptoms (3.7%-16.1%). Ongoing physical and mental health problems were also reported. The number of service members receiving mental health treatment significantly reduced between 12 and 36 months postinjury (48.1%-18.2%), while complaints of bodily pain significantly increased (40.7%-68.2%). Despite ongoing symptom reporting, few reported suicidal/homicidal ideation (6.5%-9.1%), and a substantial majority reported good/excellent health status (74.1%-90.9%) and satisfaction with their life (81.5%-90.9%). Continued support and care for all service members who sustain a combat-related moderate-to-severe TBI is recommended, regardless of the presence or absence of symptom reporting within the first few months postinjury.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense and Veterans Brain Injury Center
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: August 01, 2014
  • Citation: Brickell TA, Lange RT, French LM. Three-year outcome following moderate-to-severe TBI in U.S. military service members: a descriptive cross-sectional study. Mil Med. 2014 Aug;179(8):839-48.

Health-related quality of life within the first 5 years following military-related concurrent mild traumatic brain injury and polytrauma.

Study

Abstract

This study examined health-related quality of life within the first 5 years following concurrent mild traumatic brain injury (MTBI) and polytrauma. Participants were 167 U.S. service members who had sustained a MTBI who had completed a brief neurobehavioral evaluation within 3 months postinjury and at least one telephone follow-up interview at 6 (n = 46), 12 (n = 89), 24 (n = 54), 36 (n = 42), 48 (n = 30) or 60 months (n = 25) postinjury. Within the first 5 years postinjury, service members reported ongoing headaches (67.4% to 92.0%), bodily pain (66.7% to 88.9%), medication use (71.7% to 92.0%), mental health treatment (28.3% to 60.0%), and the need for help with daily activities (18.5% to 40.0%). Problematic alcohol consumption was common within the first 24 months postinjury (23.9% to 29.2%). Many service members were working for pay (36.0% to 70.8%) though many reported a decline in work quality (16.0% to 30.4%). Despite ongoing symptom reporting, many service members reported that their medications were effective (43.3% to 80.0%), good/excellent health status (68.0% to 80.0%), and life satisfaction (79.6% to 90.5%). A minority reported suicidal or homicidal ideation (5.6% to 14.8%). Recovery from MTBI in a military setting is complex and multifaceted. Continued support and care for all service members who sustain a combat-related MTBI with polytrauma is recommended, regardless of the presence or absence of symptom reporting within the first few months postinjury.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense and Veterans Brain Injury Center
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: August 01, 2014
  • Citation: Brickell TA, Lange RT, French LM. Health-related quality of life within the first 5 years following military-related concurrent mild traumatic brain injury and polytrauma. Mil Med. 2014 Aug;179(8):827-38.
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