Re-Engineering Systems for the Primary Care Treatment for PTSD (RESPECT-PTSD)
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Purpose
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.
| Condition | Intervention | Phase |
|---|---|---|
|
Stress Disorders, Posttraumatic Depression |
Behavioral: Three Component Model of Collaborative Care |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Reengineering Systems for the Primary Care Treatment of PTSD |
- PTSD Severity at 3 and 6 months [ Time Frame: 3 months and 6 months after initial assessment ] [ Designated as safety issue: No ]
- Depression, functioning, types and amount of mental health treatment received, and cost of care at 3 and 6 months [ Time Frame: 3 months and 6 months after initial assessment ] [ Designated as safety issue: No ]
| Enrollment: | 195 |
| Study Start Date: | March 2008 |
| Study Completion Date: | April 2012 |
| Primary Completion Date: | April 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm 1
Patients randomized to 3CM will receive telephone care management along with usual care by VA clinicians.
|
Behavioral: Three Component Model of Collaborative Care
Patients randomized to 3CM will receive telephone care management along with usual care by VA clinicians.
|
|
No Intervention: Arm 2
Patients randomized to "Usual Care" will receive care as usual by VA clinicians.
|
Detailed 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.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
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
Contacts and Locations| United States, Texas | |
| VA North Texas Health Care System, Dallas | |
| Dallas, Texas, United States, 75216 | |
| Central Texas Veterans Health Care System | |
| Temple, Texas, United States, 76504 | |
| Central Texas Veterans Health Care System - Waco | |
| Waco, Texas, United States, 76711 | |
| United States, Vermont | |
| VA Medical & Regional Office Center | |
| White River Junction, Vermont, United States, 05009-0001 | |
| Principal Investigator: | Paula P. Schnurr, PhD | VA Medical & Regional Office Center, White River |
More Information
No publications provided by Department of Veterans Affairs
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Department of Veterans Affairs |
| ClinicalTrials.gov Identifier: | NCT00373698 History of Changes |
| Other Study ID Numbers: | IAC 06-073 |
| Study First Received: | September 6, 2006 |
| Last Updated: | September 19, 2012 |
| Health Authority: | United States: Federal Government |
Keywords provided by Department of Veterans Affairs:
|
Stress Disorders, Posttraumatic Delivery of Health Care, Integrated Primary Health Care Veterans Depression |
Additional relevant MeSH terms:
|
Depression Depressive Disorder Stress Disorders, Post-Traumatic Stress Disorders, Traumatic |
Behavioral Symptoms Mood Disorders Mental Disorders Anxiety Disorders |
ClinicalTrials.gov processed this record on May 19, 2013