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Assessing the pandemic's impact on Canadian Veterans and their spouses
Multiple studies are reporting the pandemic’s impact on the mental health of Canadians, but what effect is it having on our nation’s Veterans and their spouses?
“With concerns about COVID-19 infection and drastic changes to everyday life, the pandemic is taking a toll on the health of Canadians,” explains Dr. Don Richardson, Associate Scientist at Lawson Health Research Institute and Director of the MacDonald Franklin Operational Stress Injury (OSI) Research Centre, located at St. Joseph's Health Care London's Parkwood Institute. “And it may be particularly distressing for those vulnerable to mental illness.”
Population studies show that Veterans are at double the risk of mental illness when compared to the rest of the population. They experience higher rates of depression, anxiety and loneliness. Spouses of Canadian Veterans are also at higher risk of distress, as they may sometimes undertake significant caregiving responsibilities that that require significant emotional and time investments.
“It’s currently unknown how the pandemic will impact Veterans and their spouses, but it could result in particularly serious outcomes,” says Dr. Anthony Nazarov, Associate Scientist at Lawson and the MacDonald Franklin OSI Research Centre.
In a new project from Lawson and the Centre of Excellence on Post-Traumatic Stress Disorder (PTSD), researchers will seek answers to these questions by partnering with up to 1,000 Canadian Veterans and 250 spouses of Canadian Veterans. Through online surveys, the project will hear directly from Veterans and their spouses to assess the pandemic’s effects on their well-being over time. The team hopes results can be used by health care workers and policy-makers to support Veterans and their families during both the current pandemic and future public health emergencies.
“We want to hear from all Canadian Veterans and their spouses, whether they’re doing well or not and whether they’re seeking care or not,” explains Dr. Nazarov.
From left: Drs. Don Richardson and Anthony Nazarov
Participants will complete online surveys, available in both English and French, once every three months for a total of 18 months. They will be asked questions about their psychological, social, family-related and physical well-being, and any relevant changes to their lifestyle and health care treatment.
“Veterans who regularly access health care services could encounter significant changes, including a move to virtual care appointments. This could lead to increased caregiving responsibilities for spouses,” says Dr. Nazarov. “Given the uncertainty surrounding the pandemic, these changes may persist well into the future, mandating a thorough assessment of patient satisfaction and treatment outcomes.”
The team hopes results can be used to support the wellness of Veterans and their families during public health emergencies. This includes providing health care professionals and policy-makers with information to guide emergency preparedness policies and health care delivery models. They hope results can also be used to recognize early signs of distress in order to target with early interventions.
“We are seeking to understand the impact of COVID-19 on Veterans and their families to identify if this global pandemic is leading to psychological distress or triggering historical traumas,” says Dr. Patrick Smith, CEO of the Centre of Excellence on PTSD. “The Centre’s primary goal is to increase Canadian expertise related to military and Veteran mental health, suicide prevention and substance use disorders. This study can help us understand if the pandemic is having debilitating and life-altering effects, and help us address a potential mental health crisis.”
Dr. Patrick Smith
Caitlin Cassidy
Caitlin Cassidy, MD
Assistant Professor, Schulich School of Medicine and Dentistry
Childhood Onset Conditions; Implementation Science and Education
Dr. Caitlin Cassidy is a physiatrist at Parkwood Institute and an Associate Professor in the Department of Physical Medicine and Rehabilitation, and is also cross appointed to the Department of Paediatrics. Her primary clinical and research roles revolve around the Transitional and Lifelong Care (TLC) program at Parkwood Institute. The TLC program provides longitudinal rehabilitative care to adolescents and adults living with a physical disability of childhood onset, many of whom experience mobility challenges and may struggle to find accessible opportunities to increase their fitness and activity levels.
Dr. Cassidy’s research interests include the natural history and long-term outcomes of people with these conditions, and collaborates closely with Dr. Laura Brunton from the School of Physical Therapy at Western University to determine the impacts that access to activity and wellness programming have on pain, fatigue and other outcomes for people with cerebral palsy and spina bifida. Dr. Cassidy also acts as the discipline lead for Musculoskeletal Medicine in undergraduate medical education at Schulich School of Medicine & Dentistry at Western University.
Celebrating Clinical Trials Day
Clinical trials are the gold standard in medical research, used to test new treatments and medical devices to ensure they are safe and improve patient outcomes.
Each year on May 20, Clinical Trials Day aims to raise awareness about the importance of clinical trials. At Lawson Health Research Institute, our researchers, research staff and learners across London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London (St. Joseph’s) are working daily to advance clinical trials for some of the most pressing health challenges.
“If you look at many areas of medicine, like cancer and cardiovascular disease, part of why those conditions have had dramatic improvements in outcomes over the last several decades is because of clinical trials,” says Dr. Amit Garg, Scientist at Lawson, Lead for the Kidney, Dialysis & Transplantation Research Program at ICES Western, and a Nephrologist at LHSC.
Clinical trials can also provide patient participants with new treatment options and can demonstrate when existing treatments have applications for other diseases.
“We could not conduct clinical trials without patients participating in them,” adds Dr. David Palma, Associate Scientist at Lawson and Radiation Oncologist at LHSC. “A clinical trial is a very rigorous process where we carefully define a treatment and follow patients very closely with extra interventions and tests to see not only how the disease is responding to treatment, but also any effects on a patient’s quality of life.”
It also takes a team to make clinical trials a success, including the critical work of research coordinators, associates and assistants, adds Dr. Swati Mehta, Lawson Scientist based at St. Joseph’s Parkwood Institute.
Dr. Palma also notes that while clinical trials require investment to conduct them, they can ultimately lead to savings in the health system.
“While the primary goal of a clinical trial is to improve or save lives, they often lead to cost savings down the road. Improving cure rates means people don’t need as much treatment and that can save the initial investment many, many times over,” Palma says.
Looking ahead, work is ongoing to make clinical trials more efficient and equitable.
“Eliminating specialized infrastructure would help make trials more equitable, so they are available in smaller communities and at distant sites that otherwise would not have access. Making study materials available in multiple languages and to anyone with accessibility issues can also help,” Garg adds.
“Future clinical trials will need to follow more pragmatic, adaptive study designs that allow us to evaluate therapies or interventions in a more realistic setting,” Dr. Mehta says. “These would also allow us to follow-up with patients that were potentially underrepresented in past research.”
According to researchers at Lawson, the future of clinical trials is bright with hundreds of trials currently underway at LHSC and St. Joseph’s with the goal of improving patient outcomes.