Improving function through primary care treatment of PTSD: The IMPACT study protocol.
Improving function through primary care treatment of PTSD: The IMPACT study protocol.
复制标题
通过 PTSD 的初级保健治疗改善功能：IMPACT 研究方案。
DOI：
10.1016/j.cct.2022.106881
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发表时间：
2022
影响因子：
2.2
通讯作者：
Cigrang,Jeffrey
中科院分区：
文献类型：
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作者：
Rauch,SheilaAM;Kim,HMyra;Acierno,Ron;Ragin,Carly;Wangelin,Bethany;Blitch,Kimberly;Muzzy,Wendy;Hart,Stephanie;Zivin,Kara;Cigrang,Jeffrey
尽管有针对创伤后应激障碍的有效心理干预措施，但获得和保留这些干预措施仍然存在问题。值得注意的是，退伍军人健康管理局(VHA)制定并实施了部署后健康调查，在初级保健(PC)中筛选创伤后应激障碍，但基于初级保健(PC)的有效心理干预治疗方案尚未建立。为了解决患者最初在哪里接受护理(即初级护理)和他们必须去哪里接受创伤后应激障碍一线治疗(即专门的精神健康)之间的字面上的身体差距，研究人员开发了一种4-6次探视的长期初级护理暴露(PE-PC)治疗，该治疗已显示出在减少创伤后应激障碍方面的效果。为了将先前的工作扩展到基于康复的精神卫生保健，通过初级保健治疗创伤后应激障碍(IMPACT)改善功能(IMPACT)研究审查了世界卫生组织残疾评估时间表[WHODAS 2.0；(Axelsson，Lindsäter，Ljótsson，Andersson，&Hedman-Lagerlöf，2017)]评估的功能。在VHA初级保健精神卫生综合(PCMHI)诊所就诊的患有创伤后应激障碍或严重亚综合征创伤后应激障碍的退伍军人，符合最低限度的纳入和排除标准，被随机分配到PE-PC或照常治疗(TAU)。如果被证明在改善功能方面有效，PE-PC将为高质量的创伤后应激障碍护理提供一个新的接入点，并允许更多的退伍军人获得有效的创伤后应激障碍治疗。试验登记：http://ClinicalTrials.gov：NCT03581981
Despite the availability of effective psychological interventions for PTSD, access to and retention in these interventions remains problematic. Of note, the Veterans Health Administration (VHA) developed and implemented post-deployment health surveys that screen for PTSD in primary care (PC), but effective PC-based, psychological intervention treatment options have yet to be established. To address the literal physical gap between where the patients first present for care (i.e., primary care) and where they must go to receive first-line treatment for PTSD (i.e., specialty mental health), study investigators developed a 4–6 visit Prolonged Exposure for Primary Care (PE-PC) treatment that has shown efficacy in reduction of PTSD. To extend previous work to recovery-based mental health care, the Improving Function Through Primary Care Treatment of PTSD (IMPACT) study examined function as assessed by the World Health Organization Disability Assessment Schedule [WHODAS 2.0; (Axelsson, Lindsäter, Ljótsson, Andersson, & Hedman-Lagerlöf, 2017)]. Veterans presenting in VHA primary care mental health integration (PCMHI) clinics with PTSD or significant subsyndromal PTSD who met minimal inclusion and exclusion criteria were randomly assigned to PE-PC or treatment as usual (TAU). If proven effective in improving function, PE-PC would provide a new access point for high quality PTSD care and allow greater numbers of veterans to access effective PTSD treatment.Trial Registration: http://ClinicalTrials.gov: NCT03581981