Format

Send to

Choose Destination
Telemed J E Health. 2015 Jan;21(1):42-7. doi: 10.1089/tmj.2013.0337. Epub 2014 Nov 18.

A pilot trial of telephone-based collaborative care management for PTSD among Iraq/Afghanistan war veterans.

Author information

1
1 Seattle Division, Mental Health Service, VA Puget Sound Healthcare System , Seattle, Washington.

Abstract

BACKGROUND:

Collaborative care and care management are cornerstones of Primary Care-Mental Health Integration (PC-MHI) and have been shown to reduce depressive symptoms. Historically, the standard of Veterans Affairs (VA) collaborative care was referring patients with posttraumatic stress disorder (PTSD) to specialty care. Although referral to evidence-based specialty care is ideal, many veterans with PTSD do not receive such care. To address this issue and reduce barriers to care, VA currently recommends veterans with PTSD be offered treatment within PC-MHI as an alternative. The current project outlines a pilot implementation of an established telephone-based collaborative care model-Translating Initiatives for Depression into Effective Solutions (TIDES)-adapted for Iraq/Afghanistan War veterans with PTSD symptoms (TIDES/PTSD) seen in a postdeployment primary care clinic.

MATERIALS AND METHODS:

Structured medical record extraction and qualitative data collection procedures were used to evaluate acceptability, feasibility, and outcomes.

RESULTS:

Most participants (n=17) were male (94.1%) and white (70.6%). Average age was 31.2 (standard deviation=6.4) years. TIDES/PTSD was successfully implemented within PC-MHI and was acceptable to patients and staff. Additionally, the total number of care manager calls was positively correlated with number of psychiatry visits (r=0.63, p<0.05) and amount of reduction in PTSD symptoms (r=0.66, p<0.05). Overall, participants in the pilot reported a significant reduction in PTSD symptoms over the course of the treatment (t=2.87, p=0.01).

CONCLUSIONS:

TIDES can be successfully adapted and implemented for use among Iraq/Afghanistan veterans with PTSD. Further work is needed to test the effectiveness and implementation of this model in other sites and among veterans of other eras.

KEYWORDS:

collaborative care; posttraumatic stress disorder; primary care mental health; veterans

PMID:
25405394
PMCID:
PMC4298146
DOI:
10.1089/tmj.2013.0337
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Atypon Icon for PubMed Central
Loading ...
Support Center