Homecoming Line: Telephone Support for Veterans
- Conditions
- Stress Disorders, Post-Traumatic
- Interventions
- Behavioral: Telephone Case MonitoringBehavioral: Treatment as Usual
- Registration Number
- NCT02655991
- Lead Sponsor
- VA Palo Alto Health Care System
- Brief Summary
This study will determine whether telephone support improves clinical outcomes of veterans who begin outpatient treatment for posttraumatic stress disorder. Participants will be randomly assigned to receive either usual care or usual care supplemented by biweekly monitoring and support by telephone during the first 3 months of treatment. Patients in both conditions will be compared on PTSD symptoms, engagement in treatment, violence and drinking at 4 months and 12 months after entering treatment.
- Detailed Description
This multisite randomized controlled trial will test whether a 3-month period of providing telephone monitoring to PTSD patients as a supplement to usual specialty mental health care improves 12-month clinical outcomes (a reduction in PTSD symptoms, violence, and substance use). Secondarily, this study will determine whether telephone monitoring promotes better engagement in outpatient treatment (Number of mental health and psychotherapy visits during the 3-month intervention period).
Demand for VA PTSD treatment is increasing as troops return from combat deployments in Afghanistan and Iraq. Telemedicine is likely to be an important component in developing more effective and efficient models of PTSD care that improves patient functioning and treatment utilization. It is hoped that using telephone case monitoring as an inexpensive adjunct to standard care may improve clinical outcomes and reduce hospitalization among veterans with PTSD.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 358
- VA patients newly entering outpatient treatment mental health treatment for PTSD starting a new phase of outpatient PTSD treatment (e.g., transitioning from a psycho-education group to active psychotherapy) at one of the study sites.
- Active duty personnel
- Cognitive impairment which precludes giving informed consent
- Initiating residential or inpatient treatment rather than outpatient treatment
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Telephone Case Monitoring Telephone Case Monitoring Telephone care management augmenting treatment as usual Telephone Case Monitoring Treatment as Usual Telephone care management augmenting treatment as usual Treatment as Usual Treatment as Usual Case management, psychotherapy, and pharmacotherapy as usual
- Primary Outcome Measures
Name Time Method PTSD Checklist (PCL) Slope 12 months Slope of improvement on the PTSD Checklist, a self-report measure of PTSD symptoms.
- Secondary Outcome Measures
Name Time Method Quality of Life slope 12 months Slope of improvement on a self-report quality measure used in the Veterans Affairs Military Stress Treatment Assessment study.
Other mental health visits -- follow-up period months 4-12 Number of "other" mental health visits (mental health visits without psychotherapy procedure code and/or without a PTSD diagnosis code) completed during the post-intervention period (months 4-12).
Other mental health visits - intervention period 3 months Number of "other" mental health visits (mental health visits without psychotherapy procedure code and/or without a PTSD diagnosis code) completed during the 3 month intervention period.
PTSD psychotherapy visits - intervention period 3 months Number of psychotherapy visits for PTSD (psychotherapy procedure code + PTSD diagnosis code) completed during the 3 month intervention period.
Depression slope 12 months Slope of improvement on the Center for Epidemiological Studies Scale, a self-report measure of depression symptoms.
Aggression slope 12 months Slope of improvement on a six-item self-report measure of aggressive behaviors, adapted from the Conflict Tactics Scale.
Prazosin refills (medication possession ratio) 12 months Number of days' supply of Prazosin obtained divided by 365 days.
Alcohol problems slope 12 months Slope of improvement on the Addiction Severity Index Alcohol Composite, a self-report measure of alcohol-related problems.
Drug problems slope 12 months Slope of improvement on the Addiction Severity Index Drug Composite, a self-report measure of drug-related problems.
PTSD psychotherapy visits -- follow-up period months 4-12 Number of psychotherapy visits for PTSD (psychotherapy procedure code + PTSD diagnosis code) completed during the post-intervention period (months 4-12).
Selective serotonin reuptake inhibitor refills (medication possession ratio) 12 months Number of days' supply of selective serotonin reuptake inhibitors (SSRIs) obtained divided by 365 days.
Trial Locations
- Locations (3)
VA Palo Alto Health Care System (Meno Park Division)
🇺🇸Menlo Park, California, United States
Durham VA Medical Center
🇺🇸Durham, North Carolina, United States
VA Puget Sound Health Care System (American Lake)
🇺🇸Lakewood, Washington, United States