title: A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth.
abstract: This is the first randomized controlled trial to evaluate non-inferiority of Prolonged Exposure (PE) delivered via home-based telehealth (HBT) compared to standard in-person (IP) PE. One-hundred thirty two Veterans recruited from a Southeastern Veterans Affairs Medical Center and affiliated University who met criteria for posttraumatic stress disorder (PTSD) were randomized to receive PE via HBT or PE via IP. Results indicated that PE-HBT was non-inferior to PE-IP in terms of reducing PTSD scores at post-treatment, 3 and 6 month follow-up. However, non-inferiority hypotheses for depression were only supported at 6 month follow-up. HBT has great potential to reduce patient burden associated with receiving treatment in terms of travel time, travel cost, lost work, and stigma without sacrificing efficacy. These findings indicate that telehealth treatment delivered directly into patients' homes may dramatically increase the reach of this evidence-based therapy for PTSD without diminishing effectiveness.
authors.affiliation: Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA; College of Nursing, Medical University of South Carolina, Charleston, SC, USA. Electronic address: acierno@musc.edu.
authors.forename: Ron
authors.initials: R
authors.lastname: Acierno
authors.affiliation: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Knapp
authors.affiliation: Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Tuerk
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Amanda K
authors.initials: AK
authors.lastname: Gilmore
authors.affiliation: College of Liberal Arts & Sciences, University of Kansas, Lawrence, KS, USA.
authors.forename: Carl
authors.initials: C
authors.lastname: Lejuez
authors.affiliation: Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA; College of Nursing, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Ruggiero
authors.affiliation: Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA; College of Nursing, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Muzzy
authors.affiliation: Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA.
authors.forename: Leonard
authors.initials: L
authors.lastname: Egede
authors.affiliation: Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA; College of Nursing, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Melba A
authors.initials: MA
authors.lastname: Hernandez-Tejada
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Edna B
authors.initials: EB
authors.lastname: Foa
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods; D008297:Male; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*; D017216:Telemedicine; D055815:Young Adult
keywords: Non-inferiority; PTSD; Prolonged exposure; RCT; Telehealth