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Prolonged Exposure (PE) for PTSD: Telemedicine vs. In Person

PTSD 的长期暴露 (PE)：远程医疗与面对面医疗

基本信息

批准号：
8225409
负责人：
Ronald E. Acierno
金额：
--
依托单位：
RALPH H JOHNSON VA MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-07-01 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8225409
关键词：
Address Adopted Aftercare Area Bypass Caring Client satisfaction Clinic Clinical Country Diagnosis Diagnostic Disease Equipment Evidence based practice Experimental Designs Face Freedom Future Gender Health Health Care Costs Health Services Accessibility Healthcare Home environment Hospitals Individual Intervention Iraq Measures Medical Medical center Mental Health Mental Health Services Mental disorders Methods Modality Nature Outcome Persons Phase Post-Traumatic Stress Disorders Primary Health Care Process Program Evaluation Protocols documentation Race Randomized Relative (related person)Risk Rural Services Symptoms System Telemedicine Testing Training Travel Use Effectiveness Veterans War Woman base clinical efficacy cost cost effective cost effectiveness design economic outcome effective therapy effectiveness measure experience follow-up innovation interest meetings operation outreach prevent programs rural area screening social social stigma treatment center

项目摘要

ABSTRACT Project Background/Rationale: Approximately 15 to 17% of current Iraq war veterans meet full diagnostic criteria for MH problems such as post-traumatic stress disorder (PTSD) (Hoge et al., 2004). Prolonged Exposure (PE) is an empirically supported treatment for PTSD (Foa 1997; Schnurr et al., 2007), and has been adopted by the VAMC as one of the treatments of choice for the disorder, as evident by the VAMC-sponsored national training of clinicians to use PE. It is therefore important to employ treatment delivery methods that maximize the likelihood that all veterans in need, including veterans residing in rural settings, and veterans who avoid VAMC settings due to the stigma of receiving mental health treatment, will receive interventions such as PE. The May, 2005 Committee on Veterans Affairs, Subcommittee on Health has identified Telemedicine as a VA priority area to address this need. The present proposal is to study whether PE delivered via Telemedicine is as effective as PE delivered In Person. Telemedicine has been chosen for its ability to overcome what appear to be two major barriers to mental health care (Frueh et al., 2000): the difficulty that rural-residing veterans face in reaching VAMC facilities, and the stigma veterans perceive related to receiving mental health treatment. Indeed, if effective, PE delivered via telemedicine may address the problem inherent in the finding that 42% of those screening positive for PTSD indicate that they are interested in receiving help, but only 25% actually receive services (Hoge, et al., 2006). Project Objectives: Although effective treatments for PTSD exist and have been adopted by the VAMC, barriers to care of a social (e.g., stigma) and geographic (e.g., rural) nature prevent many veterans in need from receiving care. Telemedicine might address this need. The major objective of this study is to determine if PE delivered via Telemedicine is as effective as In Person PE in terms of (1) clinical; (2) process; and (3) economic outcomes. Project Methods: We propose to use a randomized between groups repeated measures (baseline, post- treatment, 3& 6-month followups) design with 226 OIF-OEF veterans diagnosed with PTSD to assess the relative effectiveness, measured in terms of symptoms, patient satisfaction, and costs, of PE delivered via Telemedicine vs. In Person formats. We hypothesize that no differences (i.e., non-inferiority) between the two formats will be evident in terms treatment gains, patient satisfaction, treatment attrition, patient satisfaction and direct healthcare costs. Anticipated Impacts on Veterans Healthcare: This study will provide important information regarding whether PE delivered via home-based Telemedicine equipment is as effective as traditional In Person delivery of PE for post-traumatic stress disorder. If shown to be as effective as In Person treatment, a new, innovative, and cost effective intervention delivery system for PTSD will have initial empirical support.

摘要