title: Pilot Study of a Telehealth-Delivered Medication-Augmented Exposure Therapy Protocol for PTSD.
abstract: Posttraumatic stress disorder (PTSD) is a serious condition, with certain occupations at increased risk due to greater trauma exposure. These same individuals face multiple barriers to care. This study aimed to investigate the feasibility of conducting a research trial with exposure therapy delivered via videoconferencing. Eleven adults working in occupations at risk with PTSD enrolled and seven completed 12 to 15 sessions. Individuals were randomized to receive the cognitive enhancer D-cycloserine or placebo, and participants provided saliva samples for genetic analysis. Treatment completers demonstrated decreases in PTSD and depressive symptomatology (measured by CAPS [p < 0.001, d = 2.79] and BDI-II [p = 0.004, d = 0.92]). Participants reported high therapeutic alliance, treatment satisfaction, and telehealth satisfaction. There were no significant technical, medication, or safety issues, and no clinical emergencies. The results suggest that it may be feasible to conduct clinical research using telehealth for PTSD and to use telehealth to increase access to care.
authors.affiliation: *Weill Cornell Medical College, New York; †City University of New York School of Public Health, Hunter College, New York, NY; ‡University of Connecticut, Storrs, CT; and §University of Vermont College of Medicine, Burlington, VT.
authors.forename: Megan
authors.initials: M
authors.lastname: Olden
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Wyka
authors.forename: Judith
authors.initials: J
authors.lastname: Cukor
authors.forename: Melissa
authors.initials: M
authors.lastname: Peskin
authors.forename: Margaret
authors.initials: M
authors.lastname: Altemus
authors.forename: Francis S
authors.initials: FS
authors.lastname: Lee
authors.forename: Lucy
authors.initials: L
authors.lastname: Finkelstein-Fox
authors.forename: Terry
authors.initials: T
authors.lastname: Rabinowitz
authors.forename: JoAnn
authors.initials: J
authors.lastname: Difede
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D003523:Cycloserine / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D019114:Remote Consultation / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003523:Cycloserine