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IOM Urges Coordinated Care for Multisymptom Illness in Vets

Individualized treatment plans, improved communication, team approach to care needed

WEDNESDAY, Jan. 23 (HealthDay News) -- Individualized treatment plans and a team approach providing comprehensive and coordinated care is recommended for veterans with chronic multisymptom illness (CMI), a health condition which affects about one-third of 1991 Gulf War veterans, according to a report published Jan. 23 by the Institute of Medicine (IOM).

Bernard M. Rosof, M.D., from Huntington Hospital in New York, and colleagues from the IOM reviewed and analyzed current treatments for CMI.

The authors note that, in order to provide better care for veterans with CMI, efforts need to be intensified to identify veterans with CMI and integrate them into the health system. Comprehensive care should be provided for the range of symptoms a veteran displays, including CMI symptoms. For veterans with CMI, improving clinician-patient communication is essential for successful management. A team approach, with patients as active members of the team, is suggested to provide coordinated, comprehensive care for an integrated long-term management approach. Based on a current review of evidence, there is no single therapy that can manage the health of veterans with CMI; rather, individualized care management plans are encouraged. Medications such as specific serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors may be beneficial, but alternative interventions and approaches should be assessed. To facilitate sharing of information and skills for managing CMI, peer networks should be developed and CMI "champions" should serve as an internal resource for clinicians.

"In changing how it treats CMI, the Department of Veterans Affairs can make a significant difference in the lives of veterans who have the condition by helping to ensure they receive more integrated, comprehensive, and responsive health care," the authors write.

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