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Fortney JC, Pyne JM, Kimbrell TA, Hudson TJ. Six Month Outcomes for the Telemedicine Outreach for PTSD (TOP) Study. Paper presented at: International Society for Traumatic Stress Studies Annual Meeting; 2012 Nov 2; Los Angeles, CA.
Although psychotherapy and pharmacotherapy for PTSD have proven to be efficacious in controlled trials, geographic barriers often prevent rural Veterans from accessing these treatments. This effectiveness study evaluated a telemedicine-based collaborative care model designed to improve the outcomes of Veterans with PTSD treated in VA Community Based Outpatient Clinics (CBOCs) without onsite psychiatrists. Patients were recruited from 11 CBOCs using a combination of self-referral, provider-referral and opt-out-letters. For consenting participants, eligibility was assessed using the CAPS administered via interactive video. 265 Veterans were enrolled. Outcomes were assessed by telephone at 6- and 12-month follow-ups using the PDS. At baseline, the mean CAPS score was 75 and the mean PDS score was 34. Most (90%) of the sample was male and the average age was 52.2. Almost 40% of the subjects were Vietnam era Veterans and 17% were OEF/OIF Veterans. About half were service connected for PTSD and about half report that their worst trauma was combat related. Mental health comorbidity was common according to the MINI (depression - 79%, generalized anxiety disorder - 67% and panic - 44%). SF12V MCS and PCS scores were about one and a half standard deviations below the national mean. Six month outcomes will be reported.
