A randomized clinical trial of in-person vs. home-based telemedicine delivery of Prolonged Exposure for PTSD in military sexual trauma survivors

•Veterans with military sexual trauma drop out of PTSD treatment at high rates.•We compared in-person to home-based telemedicine (HBT) treatment delivery.•There was no difference in treatment dose received between in-person and HBT.•Increased treatment dose corresponded to increased treatment respon...

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Bibliographic Details
Published in:Journal of anxiety disorders 2021-10, Vol.83, p.102461-102461, Article 102461
Main Authors: Acierno, Ron, Jaffe, Anna E., Gilmore, Amanda K., Birks, Anna, Denier, Carol, Muzzy, Wendy, Lopez, Cristina M., Tuerk, Peter, Grubaugh, Anouk L.
Format: Article
Language:English
Subjects:
Home-based telemedicine
Military sexual trauma
Posttraumatic stress disorder
Prolonged Exposure
Telemedicine
Treatment dropout
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Summary:•Veterans with military sexual trauma drop out of PTSD treatment at high rates.•We compared in-person to home-based telemedicine (HBT) treatment delivery.•There was no difference in treatment dose received between in-person and HBT.•Increased treatment dose corresponded to increased treatment response.•There were no differences in PTSD symptom reductions across treatment modality. Posttraumatic stress disorder (PTSD) is common in women who experienced Military Sexual Trauma (MST). Despite Veterans Affairs Medical Center-wide screening and tailored MST services, substantial barriers to care exist, and about 50 % of those who start evidence-based treatment for PTSD drop out prematurely. Home-based telemedicine (HBT) may reduce logistical and stigma related barriers to mental health care, thereby reducing dropout. The current randomized clinical trial (NCT02417025) for women veterans with MST-related PTSD (N = 136) compared the efficacy of HBT delivery of Prolonged Exposure (PE) to in-person delivery of PE on measures of PTSD and depression, as well as on “PE dose” received. Hypotheses predicted that women in the HBT PE group would complete more sessions, and evince greater PTSD and depression symptom reduction compared to in-person PE. Results revealed that there were no differences in dose received or PTSD symptom reduction between in-person and HBT conditions; however, dose (i.e., more sessions) was related to reduced PTSD symptom severity. Future research should examine other factors associated with high PTSD treatment dropout among MST patients.
ISSN:0887-6185
1873-7897
DOI:10.1016/j.janxdis.2021.102461