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Telemedicine-based Collaborative Care Intervention Improves PTSD Outcomes among Veterans Residing in Rural Settings

december 3, 2014

A recent article in Reuters Health highlights findings from a study funded by HSR&'s Quality Enhancement Research Initiative (QUERI) that showed that for many Veterans with PTSD who live in rural settings, connecting with a mental healthcare team remotely by phone or video chats can be beneficial. A large portion (38%) of VA enrollees diagnosed with PTSD live in rural areas, and two-thirds live closer to a VA community-based outpatient clinic (CBOC) than a large VA medical center. Investigators in this study developed the Telemedicine Outreach for PTSD (TOP) intervention, in which an off-site PTSD care team used telemedicine technologies to support PTSD treatment delivered by CBOC providers. Off-site PTSD care teams included telephone nurse care managers, telephone pharmacists, and psychologists who delivered Cognitive Processing Therapy (CPT) via interactive video. Veterans in this study were randomized to the TOP intervention (n=133) or usual care (n=132) and were followed for 12 months. Findings showed that telemedicine-based collaborative care successfully engaged Veterans who lived in rural settings in evidence-based psychotherapy to improve PTSD outcomes. During the study period, more than half (55%) of the Veterans randomized to TOP received CPT compared to 12% of Veterans that were randomized to usual care. Veterans in the TOP group also had significantly larger decreases in PTSD symptoms compared to Veterans in the usual care group, as well as significantly greater reductions in depression symptom severity.

Fortney J, Pyne J, Kimbrell T, et al. Telemedicine-based collaborative care for post-traumatic stress disorder: A randomized clinical trial. JAMA Psychiatry. November 19, 2014;e-pub ahead of print.

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