Evidence map›Paper›PMID 41385258›Full record

ArticleMedical care2026

Health Care Journeys of Veterans With Gulf War Illness.

Katharine Bloeser, Justeen K Hyde, Drew A Helmer, Rendelle E Bolton, Laura M Lesnewich, L Alison Phillips, Peter J Bayley, Helena K Chandler, Susan L Santos, Mikhaela L McFarlin and 3 more

Abstract read
In one paragraph

Article in Medical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Katharine BloeserThe War Related Illness and Injury Study Center, The VA New Jersey Health Care System, East Orange, NJ.
Justeen K HydeCenter for Healthcare Organization and Implementation Research, Veterans Affairs Bedford Healthcare System, Bedford, MA.
Drew A HelmerCenter for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.
Rendelle E BoltonCenter for Healthcare Organization and Implementation Research, Veterans Affairs Bedford Healthcare System, Bedford, MA.
Laura M LesnewichThe War Related Illness and Injury Study Center, The VA New Jersey Health Care System, East Orange, NJ.
L Alison PhillipsThe War Related Illness and Injury Study Center, The VA New Jersey Health Care System, East Orange, NJ.
Peter J BayleyThe War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA.
Helena K ChandlerThe War Related Illness and Injury Study Center, The VA New Jersey Health Care System, East Orange, NJ.
Susan L SantosThe War Related Illness and Injury Study Center, The VA New Jersey Health Care System, East Orange, NJ.
Mikhaela L McFarlinThe War Related Illness and Injury Study Center, The VA New Jersey Health Care System, East Orange, NJ.
Matthew J ReinhardWar Related Illness and Injury Study Center, DC Veterans Affairs Medical Center, Washington, District of Columbia.
Rachel S StewartWar Related Illness and Injury Study Center, DC Veterans Affairs Medical Center, Washington, District of Columbia.
Lisa M McAndrewThe War Related Illness and Injury Study Center, The VA New Jersey Health Care System, East Orange, NJ.

Funding

HSRD VA I01 HX001678
6 · The paper itself

Abstract

backgroundThere is an acknowledged need to improve care for patients with persistent physical symptoms. Veterans who served in the 1990-91 Gulf War are a subpopulation of U.S. military Veterans who have been struggling with persistent physical symptoms for decades. The current study sought to characterize Veterans' historic path through the health care system and current experience of care to identify opportunities to improve care.

methodsAnalysis of interviews conducted with 31 Veterans who met criteria for Gulf War Illness (GWI) was conducted to understand Veterans' health care journeys, from symptom onset to the present.

resultsEarly in their journey, Veterans felt uncertain about the nature of their condition and how to explain it to clinicians. Veterans described a cycle of referrals to specialists to pursue individual symptoms and subsequent return to primary care with few actionable findings. During this cycle, Veterans often felt dismissed or invalidated by clinicians. Over time, most Veterans felt care became increasingly fragmented, with multiple clinicians caring for them without a plan to manage GWI and little acknowledgement of GWI as a discrete illness. Further in their journey, some Veterans were referred to tertiary centers where they encountered a more holistic approach.

conclusionsFindings point to the need to shift care for Veterans with GWI, and similar conditions, away from overly focusing on individual symptoms. Instead, primary care clinicians need training and support, potentially from tertiary care experts, to develop and implement holistic care plans that recognize GWI as a complex chronic condition.

Indexed as

Persian Gulf SyndromeVeteransAdultAgedFemaleGulf WarHumansInterviews as TopicMaleMiddle AgedPrimary Health CareQualitative ResearchReferral and ConsultationUnited Statesenvironmental exposuresGulf War Illnesshealthcare journeymilitary exposurepainpersistent physical symptomsqualitativetrustVeteran

Identifiers

PMID41385258
PMCPMC12704674

What OpenQuestion holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.