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Behav Cogn Psychother. 2018 Jan;46(1):35-49. doi: 10.1017/S135246581700039X. Epub 2017 Jul 3.

Predictors of Treatment Discontinuation During Prolonged Exposure for PTSD.

Author information

1
Ralph H. Johnson Veterans Affairs Medical Center,Charleston,SC 29401 and Department of Psychiatry and Behavioral Sciences,Medical University of South Carolina,Charleston,SC 29425.
2
Department of Psychology,Ohio University,Porter Hall,Athens,OH.
3
Ralph H. Johnson Veterans Affairs Medical Center,Charleston,SC 29401andDepartment of Psychiatry and Behavioral Sciences,Medical University of South Carolina,Charleston,SC 29425.
4
Ralph H. Johnson Veterans Affairs Medical Center,Charleston,SC 29401 and College of Nursing,Medical University of South Carolina,Charleston,SC 29425.

Abstract

BACKGROUND:

Post-traumatic stress disorder (PTSD) is a highly prevalent and impairing condition for which there are several evidence-based psychotherapies. However, a significant proportion of patients fail to complete a 'sufficient dose' of psychotherapy, potentially limiting treatment gains.

AIMS:

The present study investigated predictors of premature treatment discontinuation during a trial of prolonged exposure (PE) therapy for PTSD.

METHOD:

Combat veterans with PTSD were recruited to participate in a randomized clinical trial of PE delivered in person or via telehealth technologies. Of the 150 initial participants, 61 participants discontinued the trial before the completion of eight sessions (of an 8‒12 session protocol). Treatment condition (telehealth or in person) and factors identified by prior research (age, combat theatre, social support, PTSD symptoms) were tested as predictors of treatment discontinuation.

RESULTS:

A Cox proportional hazards model (a subtype of survival analysis) was used to evaluate predictors of treatment discontinuation. Disability status and treatment condition were identified as significant predictors of discontinuation, with a noted disability and use of telehealth demonstrating higher risk.

CONCLUSIONS:

The present findings highlight the influence of telehealth and disability status on treatment discontinuation, while minimizing the role of the previously identified variables from studies with less sensitive analyses.

KEYWORDS:

PTSD; disability; discontinuation; drop-out; telehealth; veteran

PMID:
28669360
DOI:
10.1017/S135246581700039X
[Indexed for MEDLINE]

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