Decision Aid in Veterans With Posttraumatic Stress Disorder
| Status: | Completed |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/2/2016 |
| Start Date: | June 2009 |
| End Date: | January 2014 |
| Contact: | Maha H Zayed, PHD |
| Email: | Maha.Zayed@va.gov |
| Phone: | 802-295-9363 |
The purpose of this study is to examine the effects of a decision aid on veterans with
posttraumatic stress disorder (PTSD) presenting for care. The investigators' primary
hypothesis is that patients assigned to use the decision aid will demonstrate improved
quality of decisions regarding PTSD treatment relative to patients assigned to usual care.
Improved decision quality will be examined by assessing patient's knowledge of treatments,
evaluation of the risk and benefits, ability to arrive at a decision, and certainty about
that decision. The investigators' secondary hypothesis is that patients assigned to the
decision aid will be more satisfied with their care and more compliant with their care
compared to patients assigned to receive usual care. The investigators will also determine
whether patients assigned to the decision aid, relative to patients assigned to usual care,
are more likely to receive evidence-based treatments for PTSD and experience reductions in
PTSD symptoms.
posttraumatic stress disorder (PTSD) presenting for care. The investigators' primary
hypothesis is that patients assigned to use the decision aid will demonstrate improved
quality of decisions regarding PTSD treatment relative to patients assigned to usual care.
Improved decision quality will be examined by assessing patient's knowledge of treatments,
evaluation of the risk and benefits, ability to arrive at a decision, and certainty about
that decision. The investigators' secondary hypothesis is that patients assigned to the
decision aid will be more satisfied with their care and more compliant with their care
compared to patients assigned to receive usual care. The investigators will also determine
whether patients assigned to the decision aid, relative to patients assigned to usual care,
are more likely to receive evidence-based treatments for PTSD and experience reductions in
PTSD symptoms.
Posttraumatic stress is a severe and often disabling condition affecting millions of
veterans. Within VA, significant staffing and financial resources are devoted to the mission
of treating PTSD and the anticipated need for treatment is expected to accelerate as
veterans return from the Iraq war.
Research has identified a number of successful strategies for the treatment of PTSD,
including both psychotherapy and pharmacology. Several treatments, including group
psychotherapy and benzodiazepines have demonstrated a lack of efficacy in the treatment of
PTSD. Despite this knowledge, many veterans with PTSD do not receive an evidence-based
treatment and may even receive a treatment known to not be effective. Among the group of
proven effective treatments, the patient time commitment and adverse effects differ
considerably. Patients with PTSD are often ill informed about the available treatments, and
there has been little formal effort aimed at matching the patients' preferences to a
specific treatment.
We propose to conduct a clinical trial of a decision aid for veterans with PTSD. Decision
aids are standardized, evidence-based tools to help patients choose between two or more
preference-sensitive, clinically acceptable options when there is no clear "best" option.
Decision aids are designed to provide patients with detailed balanced information about all
the viable treatment options. In addition, they seek to assist the patient in clarifying
their own values and preferences such that the patient may choose among the available
treatment options.
We believe that the use of a decision aid, compared to treatment as usual, will result in a
more patient-centered approach that ultimately will increase the likelihood of the patient
receiving evidence based care, both of which are priority goals of VHA.
veterans. Within VA, significant staffing and financial resources are devoted to the mission
of treating PTSD and the anticipated need for treatment is expected to accelerate as
veterans return from the Iraq war.
Research has identified a number of successful strategies for the treatment of PTSD,
including both psychotherapy and pharmacology. Several treatments, including group
psychotherapy and benzodiazepines have demonstrated a lack of efficacy in the treatment of
PTSD. Despite this knowledge, many veterans with PTSD do not receive an evidence-based
treatment and may even receive a treatment known to not be effective. Among the group of
proven effective treatments, the patient time commitment and adverse effects differ
considerably. Patients with PTSD are often ill informed about the available treatments, and
there has been little formal effort aimed at matching the patients' preferences to a
specific treatment.
We propose to conduct a clinical trial of a decision aid for veterans with PTSD. Decision
aids are standardized, evidence-based tools to help patients choose between two or more
preference-sensitive, clinically acceptable options when there is no clear "best" option.
Decision aids are designed to provide patients with detailed balanced information about all
the viable treatment options. In addition, they seek to assist the patient in clarifying
their own values and preferences such that the patient may choose among the available
treatment options.
We believe that the use of a decision aid, compared to treatment as usual, will result in a
more patient-centered approach that ultimately will increase the likelihood of the patient
receiving evidence based care, both of which are priority goals of VHA.
Inclusion Criteria:
- Veterans who meet criteria for Posttraumatic Stress Disorder on the Posttraumatic
Stress Disorder Checklist (PCL).
Exclusion Criteria:
- Patients must not have active substance abuse.
- Patients must not have received VA PTSD treatment within the last 12 months.
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