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Journal article
Characterization of Service Members and Veterans with Mild Traumatic Brain Injury Participating in the Department of Veterans Affairs Intensive Evaluation and Treatment Programs
Military medicine, Vol.190(September/October, Supplement 2), pp.281-287
09/01/2025
PMID: 40984143
Web of Science ID: WOS:001575873200003
Abstract
Introduction Over 514,000 active duty Service Members (SMs) have sustained traumatic brain injuries (TBIs) since 2000, with mild TBI (mTBI) emerging as the signature injury of recent wars. Although many recover fully, some experience chronic mTBI with persistent symptoms such as headaches, memory issues, post-traumatic stress disorder (PTSD), chronic pain, depression, and cognitive impairment. The 2021 Department of Veterans Affairs (VA)/Department of Defense (DOD) clinical practice guidelines (CPGs) recommend symptom-focused treatment, addressing comorbid conditions, and supporting reintegration. Congress mandated specialized centers to provide comprehensive care, research, and rehabilitation for combat-injured Veterans and SMs (V/SMs) leading to the development of Intensive Evaluation and Treatment Programs (IETPs) at 5 VA Polytrauma Rehabilitation Centers offering interdisciplinary, individualized inpatient care. The IETPs integrate rehabilitation and specialty services for V/SMs with chronic mTBI and associated health issues. Objective The study aimed to describe the IETPs and the participants it serves with chronic, multiple mTBI and comorbidities. Methods Participants were V/SMs enrolled in the VA TBI Model Systems study and admitted to 1 of the 5 IETPs between 2009 and 2023. Inclusion criteria included TBI diagnosis, age ≥16, and consent for study participation. Data included demographics, military service characteristics, TBI history, and comorbidities. Injury data represented the index TBI qualifying participants for the study, although many had multiple TBIs. Measures included Functional Independence Measure, Disability Rating Scale, PTSD Checklist, and Neurobehavioral Symptom Inventory, among others. Results There have been 821 IETP participants from the program start through 2023. Participants averaged 35.3 years at admission, were predominantly White, non-Hispanic, married men, and included active duty SMs, many from Special Operations Forces (74.2%). Discussion and Conclusions Our findings show the prevalence of participants with comorbidities at IETP admission. The 2021 VA/DOD CPGs caution against over-involvement of specialty care for mTBI but acknowledge that patients with persistent symptoms and comorbidities may benefit from specialized programs like IETPs. Chronic pain, sleep apnea, musculoskeletal issues, and hypertension were common among IETP participants, highlighting the need for intensive inpatient care to address dynamic and interactive symptoms. IETPs provide integrated treatment, removing external demands and offering opportunities for medication trials, interventions, and evidence-based therapies.
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- Title
- Characterization of Service Members and Veterans with Mild Traumatic Brain Injury Participating in the Department of Veterans Affairs Intensive Evaluation and Treatment Programs
- Publication Details
- Military medicine, Vol.190(September/October, Supplement 2), pp.281-287
- Resource Type
- Journal article
- Publisher
- Oxford University Press
- Number of pages
- 7
- Grant note
- Veterans Affairs TBI Model Systems Program of Research, VHA Central Office, Washington DC
This work was supported by the Veterans Affairs TBI Model Systems Program of Research, VHA Central Office, Washington DC, and is defined as U.S. Government work under Title 17 U.S.C. 101. Per Title 17 U.S.C. 105, copyright protection is not available for any work of the U.S. Government. This material is the result of work supported with resources and the use of facilities at the James A. Haley Veterans' Hospital. The authors would like to acknowledge the contributions of their colleague Sonia Arellano for her review.
- Identifiers
- WOS:001575873200003; 99381494654906600
- Academic Unit
- Usha Kundu, MD College of Health; Health Sciences and Administration
- Language
- English