Yuen Erica K, Gros Daniel F, Price Matthew, Zeigler Stephanie, Tuerk Peter W, Foa Edna B, Acierno Ron
University of Tampa.
Ralph H. Johnson Veterans Affairs Medical Center.
J Clin Psychol. 2015 Jun;71(6):500-12. doi: 10.1002/jclp.22168. Epub 2015 Mar 25.
Telehealth technology may reduce the effect of treatment barriers and improve participation in treatment for veterans with posttraumatic stress disorder (PTSD). The present study is an ongoing randomized controlled trial comparing the effectiveness of prolonged exposure (PE) delivered via in person or home-based video telehealth modalities.
A total of 52 veterans with combat-related PTSD were randomized to receive 8-12 weeks of PE through either home-based telehealth or standard in-person office-based care.
Participants evinced significant reductions in symptoms of PTSD, depression, and anxiety from pre- to posttreatment across both conditions. Analyses conducted within a noninferiority framework suggested nonsignificant treatment outcome differences in clinician-reported PTSD and self-reported anxiety between the conditions. Results were inconclusive for self-reported PTSD and depression symptoms. Patient satisfaction ratings did not significantly differ between the two groups.
Results suggest that PE can be delivered via home-based telehealth with outcomes and satisfaction ratings comparable to in-person practices for certain symptoms, however additional research is needed. This modality has the potential to address stigma- and geographic-related barriers to treatment, such as travel time and cost.
远程医疗技术可能会减少治疗障碍的影响,并提高创伤后应激障碍(PTSD)退伍军人的治疗参与度。本研究是一项正在进行的随机对照试验,比较通过面对面或家庭视频远程医疗方式提供的延长暴露疗法(PE)的有效性。
共有52名与战斗相关的PTSD退伍军人被随机分配,通过家庭远程医疗或标准的面对面门诊护理接受8至12周的PE治疗。
在两种治疗条件下,参与者从治疗前到治疗后的PTSD、抑郁和焦虑症状均有显著减轻。在非劣效性框架内进行的分析表明,两种治疗条件下,临床医生报告的PTSD和自我报告的焦虑症状在治疗结果上无显著差异。自我报告的PTSD和抑郁症状的结果尚无定论。两组患者的满意度评分无显著差异。
结果表明,PE可以通过家庭远程医疗提供,对于某些症状,其治疗效果和满意度评分与面对面治疗相当,然而还需要进一步的研究。这种方式有可能解决与耻辱感和地理位置相关的治疗障碍,如出行时间和费用。