VA research finds new insights on drug safety, chronic pain, infection

The VA's Office of Research and Development has released three significant research findings that could improve care for veterans dealing with medication side effects, chronic pain, and serious infections. These studies, conducted through VA research programs including the Million Veteran Program, offer new tools and treatment approaches that may directly benefit veterans receiving VA healthcare.

The Million Veteran Program is one of the world's largest health research initiatives, combining genetic data with health records from over a million veteran volunteers to advance medical knowledge. Researchers from this program recently developed a genomic atlas that can predict adverse drug reactions by analyzing nearly 17,000 genes. The team created an interactive web interface that allows filtering by gene, drug phase, and how medications work on the body, demonstrating the capacity to predict hundreds of known adverse drug reactions for approved medications and suggest other potential adverse interactions. The research found that genetic variants linked to immune-related pathways were particularly prominent in drug reactions, suggesting that medications affecting these pathways deserve special attention for safety monitoring.

In a separate study focused on chronic pain management, researchers from the VA Center for Integrated Healthcare examined whether brief cognitive behavioral therapy could help veterans with moderate to severe chronic pain. The study involved 184 veterans divided into two groups, with one group receiving usual pain care and the other receiving six 30-minute sessions of psychoeducation, behavioral and cognitive skills training, and relapse prevention over 12 weeks in addition to usual care. Veterans who received the brief cognitive therapy showed greater improvements in how much pain interfered with their daily lives during treatment, and these improvements were sustained three months after the therapy ended. The behavioral treatment also led to improved physical quality of life and better sleep quality.

The third study, conducted at the Tucson VA, examined the connection between metabolic syndrome and Clostridioides difficile infection, commonly known as C. diff. Metabolic syndrome is a condition that combines obesity with factors such as insulin resistance, high blood pressure, and low good cholesterol, increasing the risk of heart disease, stroke, and type 2 diabetes. The analysis of almost four million patients from 30 countries revealed that metabolic syndrome increased the odds of C. diff infection by 94 percent, while obesity alone increased risk by 14 percent and diabetes alone by 11 percent. Researchers explained that metabolic syndrome can alter gut bacteria and increase chronic inflammation, which affects the immune system's ability to fight off this contagious bacterium that causes diarrhea and colon inflammation.

For disabled veterans, these findings carry practical implications for ongoing healthcare management. Veterans taking multiple medications may benefit from future safety screening tools based on the genomic atlas research, particularly those with immune-related conditions who may be at higher risk for adverse drug reactions. Veterans struggling with chronic pain now have evidence supporting brief, focused cognitive behavioral therapy as an effective treatment option that doesn't require lengthy or intensive therapy commitments. Those with metabolic syndrome, obesity, or diabetes should be aware of their increased vulnerability to C. diff infection and discuss prevention strategies with their healthcare providers.

Veterans currently enrolled in VA healthcare can discuss these research findings with their primary care providers or specialists to determine whether new treatment approaches might be appropriate for their individual situations. Those interested in contributing to future VA research can learn more about the Million Veteran Program and other research opportunities through their local VA medical center. Veterans not currently enrolled in VA healthcare but eligible based on their service-connected disabilities should consider enrollment to access these advancing treatment options and participate in research that continues to improve care for all veterans.