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Wednesday, November 26, 2014

Telemedicine may be better for rural veterans with PTSD than visiting a VA clinic

Military veterans are disproportionately rural, with less ready access to treatment for post-traumatic stress disorder, but telemedicine could help rural veterans with PTSD, according to a study published in the journal JAMA Psychiatry. More than 500,000 veterans have been diagnosed with PTSD, and 66 percent of the veterans covered by the Veterans Health Administration live "closer to a VHA community-based outpatient clinic than they are to a Department of Veterans Affairs medical center," iHealthBeat reports.

The researchers wrote in the peer-reviewed journal "that it is not 'typically feasible' for outpatient clinics to hire on-site psychologists of psychiatrists who have expertise in PTSD," iHeathBeat reports.

In the study, the researchers randomly assigned 265 veterans exhibiting severe PTSD symptoms—most of whom resided in rural areas—to get either telehealth or standard care from outpatient clinics. Those with telehealth had access to "nurses who carried out care management via telephone; pharmacists available via telephone, who reviewed veterans' medication histories; psychologists, who delivered cognitive processing therapy via video chat; and psychiatrists who supervised the offsite care team and conducted interactive consultations via video chat."

The researchers measured the severity of participants' PTSD prior to and following the intervention. They also measured severity of depression and quality of life related to health. The researchers found that of those who received the PTSD telehealth intervention, 54.9 percent received cognitive processing therapy, and 27.1 percent attended at least eight cognitive processing therapy sessions. Among those who received standard care, only 12.1 percent received cognitive processing therapy, and 5.3 percent attended eight or more sessions. Also, those who received telehealth "experienced a greater decrease in severity of their PTSD symptoms and depression, compared with veterans who received standard care," iHealthBeat reports.

Although the researchers wrote that more research is necessary to further the widespread adoption of telehealth services for PTSD treatment, the study "introduced a promising model for managing PTSD in a treatment-resistant population." (Read more)

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