Randomized controlled equivalence trial comparing videoconference and in person
delivery of cognitive processing therapy for PTSD.
Author(s): Maieritsch KP(1), Smith TL(2), Hessinger JD(3), Ahearn EP(4), Eickhoff JC(5),
Zhao Q(5).
Affiliation(s): Author information:
(1)Edward Hines Jr. Veterans Administration Hospital, Illinois, USA
kelly.maieritsch@va.gov. (2)Menninger Department of Psychiatry and Behavioral
Sciences, Baylor College of Medicine, Texas, USA. (3)Edward Hines Jr. Veterans
Administration Hospital, Illinois, USA. (4)William S Middleton Veterans
Administration Hospital, University of Wisconsin Department of Psychiatry, USA.
(5)Department of Biostatistics & Medical Informatics, University of
Wisconsin-Madison, USA.
Publication date & source: 2015, J Telemed Telecare. ,
INTRODUCTION: In an effort to improve access to and utilization of health care,
the Veterans Health Administration (VHA) continues to investigate the
effectiveness of video-teleconferencing (VTC) technologies for service delivery.
While previous research focused on the efficacy of VTC treatment for
post-traumatic stress disorder (PTSD) in Vietnam era veterans, few studies have
evaluated the efficacy of this modality and treatment for the Iraq/Afghanistan
era veterans. The aim of this randomized clinical trial was to evaluate
equivalence between in person and VTC psychotherapy for PTSD in this newer
cohort.
METHODS: Veterans of the Iraq/Afghanistan conflict from two VHA hospitals in the
United States were recruited and randomized to receive cognitive processing
therapy (CPT) for PTSD either in person (IP) or over VTC. Clinician-administered
and self-report measures were collected before, during, and after treatment.
RESULTS: A trend was observed which suggested that CPT over VTC may be equivalent
to the treatment delivered in person, as suggested by previous studies.
Regardless of treatment, veterans who received the intervention in both
conditions reported significant decreases on post-treatment measures.
DISCUSSION: This study highlighted research and clinical challenges in providing
services to the newest veteran generation in general as well as unique challenges
with VTC. One complicating factor to the statistical power of this study was a
treatment dropout rate twice the original estimate. Factors that could have
influenced this high dropout rate are explored.
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