title: Posttraumatic stress disorder treatment for Operation Enduring Freedom/Operation Iraqi Freedom combat veterans through a civilian community-based telemedicine network.
abstract: BACKGROUND
  Telemedicine holds great potential to improve access to care and to reduce barriers to treatment for military populations with posttraumatic stress disorder (PTSD). This study sought to integrate the use of telemedicine mental health treatment services by a community healthcare provider to military populations residing in a rural location and to compare the equivalency of cognitive behavioral therapy (CBT) administered via telemedicine and traditional face-to-face therapy.
  
  
  METHODS
  Study subjects were men or women 18 years of age or older who had served in Operation Enduring Freedom (OEF) and/or Operation Iraqi Freedom (OIF) and were diagnosed with PTSD. The 18 study subjects were randomized and provided 10 weekly therapy sessions of CBT. Pre- and post-intervention assessments were conducted using the Clinician Administered PTSD Scale (CAPS), Hamilton Anxiety Rating Scale (HAM-A), Montgomery-Asberg Depression Rating Scale (MADRS), Life Events Checklist, and SF-36v2® (QualityMetric, Lincoln, RI) Health Survey.
  
  
  RESULTS
  The CAPS, HAM-A, and MADRS each demonstrated lower scores, signifying improvement, and 69% of subjects experienced a clinically significant change in the CAPS. Patient satisfaction results indicated greater satisfaction for telemedicine as opposed to traditional face-to-face treatment.
  
  
  CONCLUSIONS
  Findings reveal a trend expressing the equivalence of telemedicine and face-to-face therapy when treating OEF/OIF veterans with PTSD among rural populations by a community provider. It further demonstrates the successful collaboration between a community healthcare provider and the military healthcare system.
authors.affiliation: 1 Phoebe Putney Memorial Hospital , Albany, Georgia .
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Ziemba
authors.forename: Nicola S
authors.initials: NS
authors.lastname: Bradley
authors.forename: Lori-Ann P
authors.initials: LA
authors.lastname: Landry
authors.forename: Claire H
authors.initials: CH
authors.lastname: Roth
authors.forename: Linda S
authors.initials: LS
authors.lastname: Porter
authors.forename: Robert N
authors.initials: RN
authors.lastname: Cuyler
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D019058:Community Networks / Q000458:organization & administration*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000628:therapy*; D017216:Telemedicine / Q000379:methods*; D013781:Texas; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult