Videoconferencing psychotherapy for veterans with PTSD: Results from a randomized controlled non-inferiority trial
| Autor: | Leslie A. Morland, Lin Liu, Carolyn B. Allard, Carie S. Rodgers, Angela C Busch, Stephanie Y. Wells, Zia Agha, Lisa H. Glassman, Lucy Moreno, Tania Zamora, Steven R. Thorp |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male 050103 clinical psychology medicine.medical_specialty Telemedicine Health Informatics Equivalence Trials as Topic computer.software_genre Severity of Illness Index Stress Disorders Post-Traumatic 03 medical and health sciences 0302 clinical medicine Videoconferencing Non inferiority medicine Humans 0501 psychology and cognitive sciences Psychiatry Veterans business.industry 05 social sciences Middle Aged Mental health 030227 psychiatry Psychotherapy Treatment Outcome Socioeconomic Factors Non inferiority trial Female business computer |
| Zdroj: | Journal of telemedicine and telecare. 26(9) |
| ISSN: | 1758-1109 |
| Popis: | Introduction Veterans with post-traumatic stress disorder (PTSD) face significant barriers that make it less likely for them to pursue treatment. A randomized controlled non-inferiority trial was used to determine if providing psychotherapy for PTSD via videoconference (VC) is as effective as in-person (IP) psychotherapy. Methods All eligible veterans ( n = 207) received cognitive processing therapy (CPT) to treat PTSD symptoms in one of the two treatment modalities. Participant symptoms were collected at baseline, post-treatment, and six months after treatment completion. The primary outcome measure, the Clinician-Administered PTSD Scale (CAPS), was used to assess PTSD diagnosis and symptom severity. Secondary outcomes included two self-report measures of symptom severity, the Post-traumatic Stress Disorder Checklist – Specific (PCL–S) for PTSD and the Patient Health Questionnaire – 9 (PHQ–9) for depressive symptoms. A linear mixed-effects model was used to assess non-inferiority for participants who completed treatment (completers) and those who were randomized to treatment (intention-to-treat (ITT)). Results Both completer and ITT analyses showed that improvement in CAPS scores in the VC condition was non-inferior to that in the IP condition at six-month follow-up, but VC was inferior to IP for improvement in CAPS at post-treatment. Non-inferiority was supported by completer analyses for PCL–S and PHQ–9 in both post-treatment change and six-month follow-up change, and the ITT analysis supported the significant non-inferiority for PCL at post-treatment change. Discussion These findings generally suggest that CPT delivered via VC can be as effective as IP for reducing the severity of PTSD symptoms. |
| Databáze: | OpenAIRE |
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