Delivery of bright light therapy within the Veterans Health Administration.
Study Goal
The researchers aimed to investigate the delivery and utilization of bright light therapy (BLT) for mood disorders within the Veterans Health Administration (VHA) system.
Results Summary
The study found that BLT delivery in the VHA was low (1.68% of veterans with mood disorders), but increased significantly over the study period, with a seasonal peak around the winter solstice. Past mental health treatment for mood disorders was strongly associated with higher BLT consult rates.
Population
U.S. veterans receiving outpatient mood disorder-related care in the VHA from 2008 to 2020.
Effective Dosage
Not specified
Duration
Retrospective analysis spanning 12 years (October 2008 to September 2020)
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Bright light therapy (BLT) | neutral | seasonal and non-seasonal depression | - | - | is efficacious for | #1 |
light box consults | increase | BLT delivery | veterans who received outpatient mood disorder care in the Veterans Health Administration (VHA) | 548.44% | increased by | #2 |
light box consults | increase | BLT delivery | veterans who received outpatient mood disorder care in the Veterans Health Administration (VHA) | December 21st or December 22nd | displayed a robust yearly cycle that peaked on | #3 |
Past mental health treatment for a mood disorder | increase | a consult | veterans who received outpatient mood disorder care in the Veterans Health Administration (VHA) | relative risk = 4.79 | was associated with a higher probability of | #4 |
Outpatient BLT delivery | no change | BLT delivery for mood disorders in the VHA | veterans who received outpatient mood disorder care in the Veterans Health Administration (VHA) | low | remains | #5 |
Outpatient BLT delivery | increase | BLT delivery for mood disorders in the VHA | veterans who received outpatient mood disorder care in the Veterans Health Administration (VHA) | the winter solstice | displays a strong seasonal rhythm that peaks on | #6 |
BACKGROUND: Bright light therapy (BLT) is efficacious for seasonal and non-seasonal depression. However, the current state of BLT use in practice is unknown, impeding efforts to identify and address utilization gaps. This study's objective was to investigate BLT delivery in a nationwide U.S. healthcare system. METHODS: This was a retrospective observational study of electronic medical records from all veterans who received outpatient mood disorder-related care in the Veterans Health Administration (VHA) from October 2008 through September 2020. BLT delivery was measured through the placement of light box consults. RESULTS: Of the 3,442,826 veterans who received outpatient mood disorder care, only 57,908 (1.68 %) received a light box consult. Consults increased by 548.44 % (99.9 % credible interval: 467.36 %, 638.74 %) over the timeframe and displayed a robust yearly cycle that peaked on either December 21st or December 22nd. Past mental health treatment for a mood disorder was associated with a higher probability of a consult (relative risk = 4.79, 99.9 % CI: 4.21, 5.60). There was low representation related to veteran age, gender, race, and ethnicity. LIMITATIONS: No information on patients who declined light boxes or actual light box use following consult placement. CONCLUSIONS: Outpatient BLT delivery for mood disorders in the VHA remains low, despite significant growth over the past decade. It also displays a strong seasonal rhythm that peaks on the winter solstice, suggesting a limited focus on seasonal depression and a suboptimal reactive approach to changing sunlight. Overall, there exists ample opportunity for novel implementation efforts aimed at increasing utilization of BLT.