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OBJECTIVES There have been few comprehensive studies of nutrition and exercise behaviors among patients with bipolar disorder (BPD). Based on a national sample of patients receiving care in the Veterans Affairs (VA) health care system, we compared nutrition and exercise behaviors among individuals diagnosed with BPD, others diagnosed with schizophrenia, and(More)
While disease management appears to be effective in selected, small groups of CHF patients from randomized controlled trials, its effectiveness in a broader CHF patient population is not known. This prospective, quasi-experimental study compared patient outcomes under a nurse practitioner-led disease management model (intervention group) with outcomes under(More)
BACKGROUND This study examines quality of cardiometabolic care among veterans receiving care in the Veterans Affairs (VA) health system. We assess whether quality of care disparities by mental disorder status are magnified for individuals living in rural areas. RESEARCH DESIGN We identified all patients in a 2005 national Veterans Administration(More)
BACKGROUND Persons with bipolar disorder (BD) experience a disproportionate burden of medical comorbidity, notably cardiovascular disease (CVD), contributing to decreased function and premature mortality. We describe the design, rationale, and baseline findings for the Self-Management Addressing Heart Risk Trial (SMAHRT), a randomized controlled(More)
CONTEXT Comparison of outcome among intensive care units (ICUs) requires risk adjustment for differences in severity of illness and risk of death at admission to the ICU, historically obtained by costly chart review and manual data entry. OBJECTIVE To accurately estimate patient risk of death in the ICU using data easily available in hospital electronic(More)
OBJECTIVE To quantify the variability in risk-adjusted mortality and length of stay of Veterans Affairs intensive care units using a computer-based severity of illness measure. DESIGN Retrospective cohort study. SETTING A stratified random sample of 34 intensive care units in 17 Veterans Affairs hospitals. PARTICIPANTS A consecutive sample of 29,377(More)
OBJECTIVE Low adherence to antipsychotic medications is a risk factor for poor outcomes for people with serious mental illness. Pharmacy data might be used by health systems to identify partially adherent patients for interventions. This study assessed whether using pharmacy data is an accurate screening method for identifying at-risk patients. METHODS(More)
OBJECTIVE We examined cardiometabolic disease and mortality over 8 years among individuals with and without schizophrenia. METHOD We compared 65,362 patients in the Veteran Affairs (VA) health system with schizophrenia to 65,362 VA patients without serious mental illness (non-SMI) matched on age, service access year and location. The annual prevalence of(More)
We determined whether patients with serious mental illness (SMI) were less likely than non-SMI to self-report having a medical condition that was recorded in their medical record. We included all patients from the VA National Psychosis Registry diagnosed with SMI and a random sample of non-SMI patients in fiscal year 1999 who completed the Large Health(More)
BACKGROUND Valid comparison of patient survival across ICUs requires adjustment for burden of chronic illness. The optimal measure of comorbidity in this setting remains uncertain. OBJECTIVES To examine the impact of different measures of comorbid disease on predicted mortality for ICU patients. DESIGN Retrospective cohort study. SUBJECTS Seventeen(More)