Telephone monitoring and support after discharge from residential PTSD treatment: a randomized controlled trial.
Identifieur interne : 001360 ( Main/Curation ); précédent : 001359; suivant : 001361Telephone monitoring and support after discharge from residential PTSD treatment: a randomized controlled trial.
Auteurs : Craig S. Rosen [États-Unis] ; Quyen Q. Tiet ; Alex H S. Harris ; Terri F. Julian ; James R. Mckay ; William Mark Moore ; Richard R. Owen ; Susan Rogers ; Olga Rosito ; Dale E. Smith ; Mark W. Smith ; Paula P. SchnurrSource :
- Psychiatric services (Washington, D.C.) [ 1557-9700 ] ; 2013.
Descripteurs français
- KwdFr :
- MESH :
- méthodes : Post-cure.
- psychologie : Anciens combattants.
- thérapie : Troubles de stress post-traumatique.
- Adulte, Adulte d'âge moyen, Autorapport, Femelle, Humains, Liste de contrôle, Mâle, Sortie du patient, Téléphone.
English descriptors
- KwdEn :
- MESH :
- methods : Aftercare.
- psychology : Veterans.
- therapy : Stress Disorders, Post-Traumatic.
- Adult, Checklist, Female, Humans, Male, Middle Aged, Patient Discharge, Self Report, Telephone.
Abstract
OBJECTIVE
This study assessed whether adding a telephone care management protocol to usual aftercare improved the outcomes of veterans in the year after they were discharged from residential treatment for posttraumatic stress disorder (PTSD).
METHODS
In a multisite randomized controlled trial, 837 veterans entering residential PTSD treatment were assigned to receive either standard outpatient aftercare (N=425) or standard aftercare plus biweekly telephone monitoring and support (N=412) for three months after discharge. Symptoms of PTSD and depression, violence, substance use, and quality of life were assessed by self-report questionnaires at intake, discharge, and four and 12 months postdischarge. Treatment utilization was determined from the Department of Veterans Affairs administrative data.
RESULTS
Telephone case monitors reached 355 participants (86%) by phone at least once and provided an average of 4.5 of the six calls planned. Participants in the telephone care and treatment-as-usual groups showed similar outcomes on all clinical measures. Time to rehospitalization did not differ by condition. In contrast with prior studies reporting poor treatment attendance among veterans, participants in both telephone monitoring and treatment as usual completed a mental health visit an average of once every ten days in the year after discharge. Many participants had continuing problems despite high utilization of outpatient care.
CONCLUSIONS
Telephone care management had little incremental value for patients who were already high utilizers of mental health services. Telephone care management could potentially be beneficial in settings where patients experience greater barriers to engaging with outpatient mental health care after discharge from inpatient treatment.
DOI: 10.1176/appi.ps.201200142
PubMed: 23117443
PubMed Central: PMC6540753
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pubmed:23117443Le document en format XML
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<term>Aftercare (methods)</term>
<term>Checklist (MeSH)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Patient Discharge (MeSH)</term>
<term>Self Report (MeSH)</term>
<term>Stress Disorders, Post-Traumatic (therapy)</term>
<term>Telephone (MeSH)</term>
<term>Veterans (psychology)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Anciens combattants (psychologie)</term>
<term>Autorapport (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Liste de contrôle (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Post-cure (méthodes)</term>
<term>Sortie du patient (MeSH)</term>
<term>Troubles de stress post-traumatique (thérapie)</term>
<term>Téléphone (MeSH)</term>
</keywords>
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</keywords>
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<keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Anciens combattants</term>
</keywords>
<keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Veterans</term>
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<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Stress Disorders, Post-Traumatic</term>
</keywords>
<keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Troubles de stress post-traumatique</term>
</keywords>
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<term>Checklist</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Patient Discharge</term>
<term>Self Report</term>
<term>Telephone</term>
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<term>Adulte d'âge moyen</term>
<term>Autorapport</term>
<term>Femelle</term>
<term>Humains</term>
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<front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b>
</p>
<p>This study assessed whether adding a telephone care management protocol to usual aftercare improved the outcomes of veterans in the year after they were discharged from residential treatment for posttraumatic stress disorder (PTSD).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>In a multisite randomized controlled trial, 837 veterans entering residential PTSD treatment were assigned to receive either standard outpatient aftercare (N=425) or standard aftercare plus biweekly telephone monitoring and support (N=412) for three months after discharge. Symptoms of PTSD and depression, violence, substance use, and quality of life were assessed by self-report questionnaires at intake, discharge, and four and 12 months postdischarge. Treatment utilization was determined from the Department of Veterans Affairs administrative data.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Telephone case monitors reached 355 participants (86%) by phone at least once and provided an average of 4.5 of the six calls planned. Participants in the telephone care and treatment-as-usual groups showed similar outcomes on all clinical measures. Time to rehospitalization did not differ by condition. In contrast with prior studies reporting poor treatment attendance among veterans, participants in both telephone monitoring and treatment as usual completed a mental health visit an average of once every ten days in the year after discharge. Many participants had continuing problems despite high utilization of outpatient care.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>Telephone care management had little incremental value for patients who were already high utilizers of mental health services. Telephone care management could potentially be beneficial in settings where patients experience greater barriers to engaging with outpatient mental health care after discharge from inpatient treatment.</p>
</div>
</front>
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<Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">This study assessed whether adding a telephone care management protocol to usual aftercare improved the outcomes of veterans in the year after they were discharged from residential treatment for posttraumatic stress disorder (PTSD).</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">In a multisite randomized controlled trial, 837 veterans entering residential PTSD treatment were assigned to receive either standard outpatient aftercare (N=425) or standard aftercare plus biweekly telephone monitoring and support (N=412) for three months after discharge. Symptoms of PTSD and depression, violence, substance use, and quality of life were assessed by self-report questionnaires at intake, discharge, and four and 12 months postdischarge. Treatment utilization was determined from the Department of Veterans Affairs administrative data.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Telephone case monitors reached 355 participants (86%) by phone at least once and provided an average of 4.5 of the six calls planned. Participants in the telephone care and treatment-as-usual groups showed similar outcomes on all clinical measures. Time to rehospitalization did not differ by condition. In contrast with prior studies reporting poor treatment attendance among veterans, participants in both telephone monitoring and treatment as usual completed a mental health visit an average of once every ten days in the year after discharge. Many participants had continuing problems despite high utilization of outpatient care.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Telephone care management had little incremental value for patients who were already high utilizers of mental health services. Telephone care management could potentially be beneficial in settings where patients experience greater barriers to engaging with outpatient mental health care after discharge from inpatient treatment.</AbstractText>
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