A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth
This is the first randomized controlled trial to evaluate non-inferiority of Prolonged Exposure (PE) delivered via home-based telehealth (HBT) compared to standard in-person (IP) PE. One-hundred thirty two Veterans recruited from a Southeastern Veterans Affairs Medical Center and affiliated Universi...
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| Veröffentlicht in: | Behaviour research and therapy 2017-02, Vol.89, p.57-65 |
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| container_title | Behaviour research and therapy |
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| creator | Acierno, Ron Knapp, Rebecca Tuerk, Peter Gilmore, Amanda K. Lejuez, Carl Ruggiero, Kenneth Muzzy, Wendy Egede, Leonard Hernandez-Tejada, Melba A. Foa, Edna B. |
| description | This is the first randomized controlled trial to evaluate non-inferiority of Prolonged Exposure (PE) delivered via home-based telehealth (HBT) compared to standard in-person (IP) PE. One-hundred thirty two Veterans recruited from a Southeastern Veterans Affairs Medical Center and affiliated University who met criteria for posttraumatic stress disorder (PTSD) were randomized to receive PE via HBT or PE via IP. Results indicated that PE-HBT was non-inferior to PE-IP in terms of reducing PTSD scores at post-treatment, 3 and 6 month follow-up. However, non-inferiority hypotheses for depression were only supported at 6 month follow-up. HBT has great potential to reduce patient burden associated with receiving treatment in terms of travel time, travel cost, lost work, and stigma without sacrificing efficacy. These findings indicate that telehealth treatment delivered directly into patients' homes may dramatically increase the reach of this evidence-based therapy for PTSD without diminishing effectiveness.
•Prolonged Exposure (PE) decreases posttraumatic stress disorder (PTSD) symptoms.•Home-based telehealth (HBT) was compared to in person (IP) delivery of PE.•HBT-PE was non-inferior to IP-PE in terms of PTSD symptoms at post, 3 and 6 month followup points.•HBT-PE was non-inferior to IP-PE in depression symptoms at 6-month follow-up only.•HBT-PE can increase the reach of this evidence-based treatment for PTSD. |
| doi_str_mv | 10.1016/j.brat.2016.11.009 |
| format | Article |
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•Prolonged Exposure (PE) decreases posttraumatic stress disorder (PTSD) symptoms.•Home-based telehealth (HBT) was compared to in person (IP) delivery of PE.•HBT-PE was non-inferior to IP-PE in terms of PTSD symptoms at post, 3 and 6 month followup points.•HBT-PE was non-inferior to IP-PE in depression symptoms at 6-month follow-up only.•HBT-PE can increase the reach of this evidence-based treatment for PTSD.</description><identifier>ISSN: 0005-7967</identifier><identifier>EISSN: 1873-622X</identifier><identifier>DOI: 10.1016/j.brat.2016.11.009</identifier><identifier>PMID: 27894058</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Clinical trials ; Efficacy ; Female ; Home based ; Humans ; Implosive Therapy - methods ; Inferiority ; Male ; Mental depression ; Non-inferiority ; Post traumatic stress disorder ; Prolonged exposure ; PTSD ; RCT ; Stigma ; Stress Disorders, Post-Traumatic - therapy ; Telehealth ; Telemedicine ; Travel ; Veterans ; Young Adult</subject><ispartof>Behaviour research and therapy, 2017-02, Vol.89, p.57-65</ispartof><rights>2016</rights><rights>Published by Elsevier Ltd.</rights><rights>Copyright Pergamon Press Inc. Feb 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c582t-1810c8e348724a57623a82506c015b7175c8d7b2203f0b576bdfa35892d9fede3</citedby><cites>FETCH-LOGICAL-c582t-1810c8e348724a57623a82506c015b7175c8d7b2203f0b576bdfa35892d9fede3</cites><orcidid>0000-0001-8799-8210</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.brat.2016.11.009$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,315,781,785,886,3551,27929,27930,31004,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27894058$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Acierno, Ron</creatorcontrib><creatorcontrib>Knapp, Rebecca</creatorcontrib><creatorcontrib>Tuerk, Peter</creatorcontrib><creatorcontrib>Gilmore, Amanda K.</creatorcontrib><creatorcontrib>Lejuez, Carl</creatorcontrib><creatorcontrib>Ruggiero, Kenneth</creatorcontrib><creatorcontrib>Muzzy, Wendy</creatorcontrib><creatorcontrib>Egede, Leonard</creatorcontrib><creatorcontrib>Hernandez-Tejada, Melba A.</creatorcontrib><creatorcontrib>Foa, Edna B.</creatorcontrib><title>A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth</title><title>Behaviour research and therapy</title><addtitle>Behav Res Ther</addtitle><description>This is the first randomized controlled trial to evaluate non-inferiority of Prolonged Exposure (PE) delivered via home-based telehealth (HBT) compared to standard in-person (IP) PE. One-hundred thirty two Veterans recruited from a Southeastern Veterans Affairs Medical Center and affiliated University who met criteria for posttraumatic stress disorder (PTSD) were randomized to receive PE via HBT or PE via IP. Results indicated that PE-HBT was non-inferior to PE-IP in terms of reducing PTSD scores at post-treatment, 3 and 6 month follow-up. However, non-inferiority hypotheses for depression were only supported at 6 month follow-up. HBT has great potential to reduce patient burden associated with receiving treatment in terms of travel time, travel cost, lost work, and stigma without sacrificing efficacy. These findings indicate that telehealth treatment delivered directly into patients' homes may dramatically increase the reach of this evidence-based therapy for PTSD without diminishing effectiveness.
•Prolonged Exposure (PE) decreases posttraumatic stress disorder (PTSD) symptoms.•Home-based telehealth (HBT) was compared to in person (IP) delivery of PE.•HBT-PE was non-inferior to IP-PE in terms of PTSD symptoms at post, 3 and 6 month followup points.•HBT-PE was non-inferior to IP-PE in depression symptoms at 6-month follow-up only.•HBT-PE can increase the reach of this evidence-based treatment for PTSD.</description><subject>Adult</subject><subject>Clinical trials</subject><subject>Efficacy</subject><subject>Female</subject><subject>Home based</subject><subject>Humans</subject><subject>Implosive Therapy - methods</subject><subject>Inferiority</subject><subject>Male</subject><subject>Mental depression</subject><subject>Non-inferiority</subject><subject>Post traumatic stress disorder</subject><subject>Prolonged exposure</subject><subject>PTSD</subject><subject>RCT</subject><subject>Stigma</subject><subject>Stress Disorders, Post-Traumatic - therapy</subject><subject>Telehealth</subject><subject>Telemedicine</subject><subject>Travel</subject><subject>Veterans</subject><subject>Young Adult</subject><issn>0005-7967</issn><issn>1873-622X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNp9kVFrFDEQx4Mo9qx-AR8k4IsvuybZzSYrIpRSbaGgDwq-hWx2tpdjLzkn2dN-e3NcLdUHn2aG-c2fmfkT8pKzmjPevd3UA9pci5LXnNeM9Y_IimvVVJ0Q3x-TFWNMVqrv1Al5ltKmlI0W7Ck5EUr3LZN6RX6e0RBD5cME6CP6fEszejvTONEvGOcYbmCkF792MS0IdIpIS5oz2mVrs3c0ZYSU6OhTxBHwHb0KdAeYYqD7EpZE13EL1WBT0ckwwxrsnNfPyZPJzgle3MVT8u3jxdfzy-r686er87PrykktcsU1Z05D02olWitVJxqrhWSdY1wOiivp9KgGIVgzsaH0h3GyjdS9GPsJRmhOyYej7m4ZtjA6CGX12ezQby3emmi9-bsT_NrcxL2RQgilRBF4cyeA8ccCKZutTw7m2QaISzJct23HOtHKgr7-B93EBUM5z_CetUq1UvFCiSPlMKaEMN0vw5k5-Go25uCrOfhqODfF1zL06uEZ9yN_jCzA-yMA5Zl7D2iS8xAcjB7BZTNG_z_9347Ztm0</recordid><startdate>20170201</startdate><enddate>20170201</enddate><creator>Acierno, Ron</creator><creator>Knapp, Rebecca</creator><creator>Tuerk, Peter</creator><creator>Gilmore, Amanda K.</creator><creator>Lejuez, Carl</creator><creator>Ruggiero, Kenneth</creator><creator>Muzzy, Wendy</creator><creator>Egede, Leonard</creator><creator>Hernandez-Tejada, Melba A.</creator><creator>Foa, Edna B.</creator><general>Elsevier Ltd</general><general>Elsevier Science Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7TK</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8799-8210</orcidid></search><sort><creationdate>20170201</creationdate><title>A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth</title><author>Acierno, Ron ; Knapp, Rebecca ; Tuerk, Peter ; Gilmore, Amanda K. ; Lejuez, Carl ; Ruggiero, Kenneth ; Muzzy, Wendy ; Egede, Leonard ; Hernandez-Tejada, Melba A. ; Foa, Edna B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c582t-1810c8e348724a57623a82506c015b7175c8d7b2203f0b576bdfa35892d9fede3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Clinical trials</topic><topic>Efficacy</topic><topic>Female</topic><topic>Home based</topic><topic>Humans</topic><topic>Implosive Therapy - methods</topic><topic>Inferiority</topic><topic>Male</topic><topic>Mental depression</topic><topic>Non-inferiority</topic><topic>Post traumatic stress disorder</topic><topic>Prolonged exposure</topic><topic>PTSD</topic><topic>RCT</topic><topic>Stigma</topic><topic>Stress Disorders, Post-Traumatic - therapy</topic><topic>Telehealth</topic><topic>Telemedicine</topic><topic>Travel</topic><topic>Veterans</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Acierno, Ron</creatorcontrib><creatorcontrib>Knapp, Rebecca</creatorcontrib><creatorcontrib>Tuerk, Peter</creatorcontrib><creatorcontrib>Gilmore, Amanda K.</creatorcontrib><creatorcontrib>Lejuez, Carl</creatorcontrib><creatorcontrib>Ruggiero, Kenneth</creatorcontrib><creatorcontrib>Muzzy, Wendy</creatorcontrib><creatorcontrib>Egede, Leonard</creatorcontrib><creatorcontrib>Hernandez-Tejada, Melba A.</creatorcontrib><creatorcontrib>Foa, Edna B.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Behaviour research and therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Acierno, Ron</au><au>Knapp, Rebecca</au><au>Tuerk, Peter</au><au>Gilmore, Amanda K.</au><au>Lejuez, Carl</au><au>Ruggiero, Kenneth</au><au>Muzzy, Wendy</au><au>Egede, Leonard</au><au>Hernandez-Tejada, Melba A.</au><au>Foa, Edna B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth</atitle><jtitle>Behaviour research and therapy</jtitle><addtitle>Behav Res Ther</addtitle><date>2017-02-01</date><risdate>2017</risdate><volume>89</volume><spage>57</spage><epage>65</epage><pages>57-65</pages><issn>0005-7967</issn><eissn>1873-622X</eissn><abstract>This is the first randomized controlled trial to evaluate non-inferiority of Prolonged Exposure (PE) delivered via home-based telehealth (HBT) compared to standard in-person (IP) PE. One-hundred thirty two Veterans recruited from a Southeastern Veterans Affairs Medical Center and affiliated University who met criteria for posttraumatic stress disorder (PTSD) were randomized to receive PE via HBT or PE via IP. Results indicated that PE-HBT was non-inferior to PE-IP in terms of reducing PTSD scores at post-treatment, 3 and 6 month follow-up. However, non-inferiority hypotheses for depression were only supported at 6 month follow-up. HBT has great potential to reduce patient burden associated with receiving treatment in terms of travel time, travel cost, lost work, and stigma without sacrificing efficacy. These findings indicate that telehealth treatment delivered directly into patients' homes may dramatically increase the reach of this evidence-based therapy for PTSD without diminishing effectiveness.
•Prolonged Exposure (PE) decreases posttraumatic stress disorder (PTSD) symptoms.•Home-based telehealth (HBT) was compared to in person (IP) delivery of PE.•HBT-PE was non-inferior to IP-PE in terms of PTSD symptoms at post, 3 and 6 month followup points.•HBT-PE was non-inferior to IP-PE in depression symptoms at 6-month follow-up only.•HBT-PE can increase the reach of this evidence-based treatment for PTSD.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>27894058</pmid><doi>10.1016/j.brat.2016.11.009</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-8799-8210</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Adult Clinical trials Efficacy Female Home based Humans Implosive Therapy - methods Inferiority Male Mental depression Non-inferiority Post traumatic stress disorder Prolonged exposure PTSD RCT Stigma Stress Disorders, Post-Traumatic - therapy Telehealth Telemedicine Travel Veterans Young Adult |
| title | A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth |
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