Postdeployment Polytrauma Diagnoses Among Soldiers and Veterans Using the Veterans Health Affairs Polytrauma System of Care and Receipt of Opioids, Nonpharmacologic, and Mental Health Treatments.
Rachel Sayko Adams, Mary Jo Larson, Esther L Meerwijk and 2 others
PMID 31058759WHAT IT FOUND
Post-deployment soldiers and veterans using VHA polytrauma care often had chronic pain (76.5%), PTSD (53.1%) or TBI (48.6%), frequently together; mental health treatment was common (83.8%), while opioid prescriptions (26.6%) and physical therapy-based care were less frequent.
Key findings
01Within the first year after deployment, 16,590 soldiers and veterans used the VHA Polytrauma System of Care, and among them chronic pain was most common (76.5%), followed by PTSD (53.1%) and TBI (48.6%).
02The conditions were often combined: 27.6% of PSC users had the polytrauma clinical triad, while only 17.9% had chronic pain alone, 4.4% had PTSD alone, and 3.7% had TBI alone.
03In the year after first PSC use, 83.8% received specialty mental health treatment; 26.6% filled at least one opioid prescription, and the most common nonpharmacologic treatments were exercise therapy (26.5%) and other physical therapy (19.6%).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study counted care recorded in VHA administrative data, so treatment received in the Military Health System, private insurance, or other settings may be missing. Nearly 20% of PSC users were not VHA enrollees at first use, and their care outside the VHA was not observed. The researchers did not examine TBI severity, substance use, sleep problems, depression, or anxiety, so the clinical picture is incomplete. Nonpharmacologic and mental health treatments delivered outside VHA specialty records may not have been captured. Administrative codes can be misattributed by providers, and findings may not generalize to other service branches. This is a descriptive cohort, not a comparison of treatments, so it cannot say which treatment improved pain, PTSD, TBI, or function.
Declared interests
The authors declare no conflicts of interest. The article is listed as supported by NIH extramural and U.S. government non-PHS funding.
The easy way to misread this
Do not read these percentages as evidence that opioids, nonpharmacologic therapy, or mental health care improved symptoms. The study describes what treatments were recorded in VHA records after polytrauma care, not whether those treatments worked.