Re-Engineering Systems for the Primary Care Treatment for PTSD (RESPECT-PTSD)

US Department of Veterans Affairs (VA)

Status and phase: Completed; Phase 3

Conditions: Stress Disorders, Posttraumatic; Depression

Treatments: Behavioral: Three Component Model of Collaborative Care

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT00373698

IAC 06-073

Details and patient eligibility

About

The study is an evaluation of a systemic intervention to enhance the delivery of care according to practice guidelines for posttraumatic stress disorder (PTSD). The immediate objectives are to (1) implement three component model (3CM) in VA primary care clinics; and (2) evaluate the effects of 3CM on clinician behavior and patient outcomes. The long-term objectives are to generate information to support implementation research on the RESPECT model for treating PTSD in primary care and ultimately, the implementation of the model in VHA to provide care to veterans with PTSD.

Full description

3CM consists of (1) a prepared practice, (2) care management, and (3) enhanced mental health support. A prepared practice refers to education for primary care clinicians and office staff about practice guidelines and evidence-based care, the skills needed for use of assessment measures, and the use of communication forms and routines. The education plan consists of predisposing activities, including active teaching and learning, and enabling and reinforcing activities in order to help clinicians use newly acquired skills and to reinforce the continued use of these skills in practice. Care management is accomplished by telephone, usually by a centrally located care manager during acute phase treatment and follow up to answer patient questions, promote adherence to the clinician's management plan, and help patients overcome barriers to adherence. Enhanced mental health support is provided by a psychiatrist who supervises care managers by telephone, provides informal consultation to primary care clinicians, and helps to increase the quantity or quality of mental health referral resources.

Enrollment: 195 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Military Veterans in Primary Care Clinics who meet diagnostic criteria for PTSD in one of the 5 sites in Texas where this study is being conducted.
• Must have regular access to a telephone and speak English.

Exclusion criteria

• Cognitive impairment
• A history of psychosis or mania
• Prominent current suicidal ideation
• Current substance dependence
• Current engagement in mental health treatment

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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195 participants in 2 patient groups

Three Component Model

Experimental group

Description:

Three Component Model of Collaborative Care: Patients randomized to 3CM will receive telephone care management along with usual care by VA clinicians.

Treatment:

Behavioral: Three Component Model of Collaborative Care

Usual Care

No Intervention group

Description:

Patients randomized to "Usual Care" will receive care as usual by VA clinicians.