Increasing engagement in evidence-based PTSD treatment through shared decision-making: a pilot study.
Within the Veterans Health Administration, post-traumatic stress disorder (PTSD) treatment decisions are left to the patient and provider, allowing substantial variability in the way treatment decisions are made. Theorized to increase treatment engagement, shared decision-making interventions provide a standardized framework for treatment decisions. This study sought to develop (phase 1) and pilot test the feasibility and potential effectiveness (phase 2) of a brief shared decision-making intervention to promote engagement in evidence-based PTSD treatment. An initial version of the intervention was developed and then modified according to stakeholder feedback. Participants in the pilot trial were 27 Iraq and Afghanistan Veterans recruited during an intake assessment at a Veterans Affairs PTSD clinic. Participants randomized to the intervention condition (n = 13) participated in a 30-minute shared decision-making session, whereas patients randomized to the usual care condition (n = 14) completed treatment planning during their intake appointment, per usual clinic procedures. Among the 20 study completers, a greater proportion of participants in the intervention condition preferred an evidence-based treatment and received an adequate (≥9 sessions) dose of psychotherapy. Results provide preliminary support for the feasibility and potential effectiveness of the intervention and suggest that larger-scale trials are warranted.
VA HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, (MEDVAMC 152), 2002 Holcombe Boulevard, Houston, TX 77030.
Juliette M
JM
Mott
VA HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, (MEDVAMC 152), 2002 Holcombe Boulevard, Houston, TX 77030.
Melinda A
MA
Stanley
VA HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, (MEDVAMC 152), 2002 Holcombe Boulevard, Houston, TX 77030.
Richard L
RL
Street
VA HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, (MEDVAMC 152), 2002 Holcombe Boulevard, Houston, TX 77030.
Rebecca H
RH
Grady
VA HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, (MEDVAMC 152), 2002 Holcombe Boulevard, Houston, TX 77030.
Ellen J
EJ
Teng
D000328:Adult; D003657:Decision Making; D019317:Evidence-Based Medicine; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D010349:Patient Compliance; D010358:Patient Participation; D010865:Pilot Projects; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*; D014728:Veterans / Q000523:psychology; D055815:Young Adult