Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website

RRP 13-447 – HSR Study

 
RRP 13-447
SUD Treatment for Dually Diagnosed Patients in PTSD Outpatient Programs
Quyen Q. Tiet, PhD
VA Palo Alto Health Care System, Palo Alto, CA
Palo Alto, CA
Funding Period: July 2014 - June 2016
BACKGROUND/RATIONALE:
There is a high rate of comorbidity between posttraumatic stress disorder (PTSD) and substance use disorder (SUD). However, these individuals usually do not access treatment adequately, and it is common that substance use problems are not detected or treated among Veterans receiving services in PTSD specialty outpatient treatment programs.

OBJECTIVE(S):
The overarching goal of this developmental evaluation study aims to examine access to PTSD treatment and to describe SUD treatment practices for patients with co-occurring PTSD and SUD disorders. The primary aim (AIM 1) of this study focuses on identifying modifiable factors that are associated with PTSD programs serving a higher percentage of patients identified as having SUDs. AIM 2 focuses on describing SUD Treatment practices within PTSD specialty outpatient treatment programs, and identifying practices that are associated with programs that provide evidence-based treatment to a higher percentage of patients with co-occurring PTSD/SUD disorders. AIM 3 focuses on identifying models of systemic assessment and monitoring of PTSD (e.g., PCL) and SUD (e.g., BAM) outcomes that are adopted by existing programs, reasons that such models are adopted, and how such models facilitate evidence-based SUD or integrated PTSD/SUD services.

METHODS:
The proposed study will use the Northeast Program Evaluation Center (NEPEC) report data and the National Patient Care Database data to stratify existing PTSD outpatient treatment programs into quartiles of PTSD outpatient treatment programs, based on the percentage of SUD patients being served and percentage of patient receiving timely dose of SUD treatment. Fifteen programs at the top quartile for both criteria and fifteen programs at the bottom quartile for both criteria will be selected (2 quartiles x15 programs = 30 programs). We will administer a survey and then follow up with an interview with the program director and the PTSD/SUD specialist in each program (2 interviews X 30 programs). Data will be transcribed verbatim and analyzed based on themes of the contents using standard qualitative data analytical methodology, guided by the Promoting Action on Research Implementation in Health Services (PARIHS) framework. Based on results of the qualitative data, profiles of PTSD specialty outpatient treatment programs will be identified and examined for each of the study aims.

FINDINGS/RESULTS:
The project is currently conducting data analysis and getting ready for preparing reports, presentations and publications.

No results are available at this point.

IMPACT:
The findings of the study will hopefully lead to more patients with comorbid PTSD and SUD being served in PTSD specialty outpatient treatment programs by (1) improving the integrated and/or co-located treatment of SUD and co-occurring PTSD disorders, (2) improving practices that are associated with higher likelihood of detecting and providing SUD treatment (e.g., psychotherapy, pharmacotherapy, smoking cessation) among patients treated in PTSD specialty outpatient programs, and (3) reducing barriers to PTSD treatment entry for Veterans with SUD disorders.


External Links for this Project

NIH Reporter

Grant Number: I21HX001527-01
Link: https://reporter.nih.gov/project-details/8727922

Dimensions for VA

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

Learn more about Dimensions for VA.

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
    Search Dimensions for this project

PUBLICATIONS:

Journal Articles

  1. Tiet QQ, Leyva YE, Blau K, Turchik JA, Rosen CS. Military sexual assault, gender, and PTSD treatment outcomes of U.S. Veterans. Journal of traumatic stress. 2015 Apr 1; 28(2):92-101. [view]
  2. Koo KH, Tiet QQ, Rosen CS. Relationships between racial/ethnic minority status, therapeutic alliance, and treatment expectancies among veterans with PTSD. Psychological Services. 2016 Aug 1; 13(3):317-21. [view]


DRA: Mental, Cognitive and Behavioral Disorders, Substance Use Disorders
DRE: Treatment - Comparative Effectiveness
Keywords: none
MeSH Terms: none

Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.