Telemedicine Can Help Treat Veterans With PTSD In Rural Areas

20100129b1A significant number of veterans across the country experience post-traumatic stress disorder (PTSD), but access to trained mental health professionals is far from equal. Those in rural areas often struggle to find the help they need. However, a new study suggests using remote phone and video chats to connect with a trained mental health team can improve treatment for veterans in under-served areas.

According to the report published in JAMA Psychiatry, at least 500,000 veterans in the Veterans Health Administration (VHA) system, or nearly 10 percent of the VHA population were diagnosed with PTSD in 2012.

Previous studies have indicated the effectiveness of PTSD treatments delivered by interactive video are equal to traditional therapy given in person, according to lead author John Fortney of the VA Puget Sound Health Care System in Seattle, Washington.

“PTSD services are available to all Veterans enrolled in the VA, but each veteran’s perceptions about their access to care can depend on many factors,” Fortney told Reuters Health by email.

“We know that 38 percent of VA patients diagnosed with PTSD live in rural areas, and that two thirds live closer to one of VA’s 825 Community Based Outpatient Clinics than to a large Medical Center (VAMC), which underscores the importance of striving to provide the highest quality PTSD care in these clinics,” he said.

In the latest study, 265 middle-aged veterans exhibiting severe PTSD symptoms were recruited from outpatient clinics without onsite psychiatrists or psychologists from 2009 through 2011.

Half of the participants were given traditional therapy, while the other half were connected to an additional care team at a larger medical center via telemedicine, including nursing care managers and pharmacists calling their homes and psychiatrists providing consultations by video-chat at the outpatient clinic. The psychiatrists then offered feedback and recommendations to healthcare providers at the clinic through electronic medical records.

Psychologists delivered cognitive processing therapy, a specific behavioral therapy developed to treat PTSD, by video chat. During the study, more than half of the telemedicine group received cognitive processing therapy, compared to 12 percent of the comparison group.

Patients in the telemedicine group had bigger decreases in Posttraumatic Diagnostic Scale scores at the six and 12-month mark than the comparison group, according to the authors. There was no difference in medicines prescribed or taken between the two groups, the authors write.

“Many components of the telemedicine-based collaborative care model are currently available in the VA, including care manager programs, telepsychiatry, and in person Cognitive Processing Therapy,” Fortney concludes. “However, it is not common to see the delivery of Cognitive Processing Therapy combined with the other components of the telemedicine-based collaborative care model.”

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