VA Research Wrap Up: New findings on loneliness, Parkinson’s disease and asthma

This week, VA’s Office of Research and Development published three News Briefs highlighting research advances in how writing caring letters combats loneliness, Parkinson’s disease and asthma medication.

Writing caring letters has similar benefits to receiving them

VA researchers with the Center of Innovation for Complex Chronic Healthcare (CINCCH) learned volunteers with spinal cord injury/dysfunction (SCI/D) who wrote caring letters to those with the same condition reported less loneliness by the end of a 6-month program. The positive effects of receiving caring letters are well-documented, but this novel study found that those who wrote the letters also benefited from the experience. The 28 volunteers received training in writing caring letters and then wrote one letter a month for six months. They showed significant reductions in loneliness after the program, as well as reporting positive experiences of serving others and time to reflect on their circumstances related to SCI/D. The findings suggest peer-based acts of kindness may be helpful for both parties to reduce loneliness. View the full study from the “Journal of Spinal Cord Medicine.”

Behavioral therapy proven effective for Parkinson’s

VA Birmingham/Atlanta Geriatric Research Education and Clinical Center researchers found behavioral therapy worked just as well as medication to improve overactive bladder symptoms in patients with Parkinson’s disease. Furthermore, the participants in the therapy group did not experience falls or dry mouth at the same rate as those taking medications.

Overactive bladder and incontinence are common in people with Parkinson’s disease and are often factors in loss of independence, but the drugs used to treat these conditions can increase the risk of falling. The researchers randomized 77 elderly patients with Parkinson’s disease into two groups: one receiving medication and the other receiving behavioral therapy, such as pelvic floor muscle exercises and urge-suppression strategies. As both groups had similar bladder symptom improvements after 12 weeks of treatment, the results suggest behavioral therapy is effective at reducing bladder symptoms in elderly patients with Parkinson’s disease while avoiding the detrimental side-effects of medication. View the full study from “JAMA Neurology.”

Dry-powder inhalers may have adverse outcomes

VA Center for Clinical Management Research investigators identified a 5% increase in all-cause emergency department visits, an 8% increase in all-cause hospitalizations, a 10% increase in respiratory-related hospitalizations and a 24% increase in pneumonia-specific hospitalizations among Veterans with chronic obstructive pulmonary disease (COPD) and asthma, following a switch from metered-dose inhalers to dry-powder inhalers. There was no change in the number of patient deaths.

In 2021, VA made the switch between the two inhalers based on cost analysis and environmental benefits. The researchers examined the health records of nearly 260,000 Veterans prescribed an inhaler for COPD or asthma from January 2018 to December 2022. They found that the increased adverse outcomes were associated with three elements: the medication change itself, the device and delivery of the medication, and other factors such as disruptions in treatment routines and difficulties in implementation. The findings suggest a need to re-evaluate the type of inhaler medication prescribed in VA. View the full study from “JAMA Internal Medicine.”

For more Office of Research and Development updates, visit ORD online or go to https://www.research.va.gov/news_briefs/.