January 17, 2001      

Demonstration Projects for Treatment of Gulf War Illnesses

(Overview, Executive Summaries and Full Reports)

In 1998, VA established five Demonstration Projects for Treatment of Gulf War Veterans’ Illnesses, based on Public Law 105-114. The goal was to test new and innovative approaches for treating Gulf War veterans who suffer from undiagnosed and ill-defined disabilities. A second goal was to improve the satisfaction of veterans who received such health care. Below are links to executive summaries and full final reports for these clinical demonstration projects.

VA strongly supported these demonstration projects, based in part on our understanding that tradition approaches to military and veteran health care may not always adequately address all the health needs of some veterans. Today, many VA clinicians appreciate that combat casualties do not always result in obvious wounds, and that some veterans return from war with difficult to diagnose yet nevertheless debilitating health problems.

Unfortunately, we do not yet fully understand the causes of many of the illnesses suffered by veterans returning from wars and peacekeeping missions, and therefore we often have difficulty finding effective treatments. In response, veterans themselves, veteran service organizations, Congress and others have demanded that we develop new ways of responding to the health needs of American veterans. I believe that the 5 Demonstration Projects are one creative and important way that VA has responded to this issue.

$5M was made available to fund these programs, starting in July 1998, at VA Medical Centers distributed throughout the United States. Demonstration Project proposals were asked to incorporate: 

• A specialized clinic which serves Gulf War veterans;           
• Multidisciplinary treatment aimed at managing symptoms; and           
• The use of case managers.

The Demonstration Projects are now completed. The array of innovative approaches that were investigated is impressive. This final summary has been prepared to help other VAMCs to consider how they might incorporate the results into their own patient care mission. Comparative costs of different approaches were also evaluated.

Some highlights include: 

• Use of mental stress and cognitive symptom management;           
• Impact and treatment of sleep disorders in Gulf War veterans;           
• Effective use of residential rehabilitation programs;           
• Impact of case management on patient satisfaction;           
• Use of mental health case management’           
• Effective integration of case managers and related support services;           
• Effective focus on health related quality of life issues; and           
• Impact of comorbidity on approaches to effective treatment.

Executive Summariesand Full Final Reports and Abstracts of VA Gulf War Veterans’ Clinical Demonstration Programs

• Birmingham VAMC,  Project Title:  Special Emphasis Clinics with Increased Support Services Improve Gulf War Veteran Patient Satisfaction and Functional Outcomes   
  • Birmingham Executive Summary and Birmingham Full Final Report
• Boston Area VAMC's,  Project Title: Treating Sleep Disorders in Gulf War Veterans 
  • Boston Area's Executive Summary and Boston Area's Full Final Report 
• Cincinnati/Cleveland VAMC's,  Project Title: Brief Targeted Treatment Can Improve Health-Related Quality Of Life in Symptomatic Gulf War Veterans   
  • Cincinnati/Cleveland's Executive Summary and Cincinnati/Cleveland's Full Final Report 
  • Abstract
• Portland/Puget Sound VAMC's,  Project Title: Innovative Approaches At Gulf War Veteran Clinical Programs 
  • Portland/Puget Sound Executive Summary and Portland/Puget Sound Full Final Report
• Tampa VAMC,  Project Title: Case-Management on Gulf War Veteran Patient Satisfaction
  • Tampa Executive Summary and Tampa Full Final Report