A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth

Ron Acierno; Rebecca Knapp; Peter Tuerk; Amanda K. Gilmore; Carl Lejuez; Kenneth Ruggiero; Wendy Muzzy; Leonard Egede; Melba A. Hernandez-Tejada; Edna B. Foa

doi:10.1016/j.brat.2016.11.009

A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth

Ron Acierno
, Rebecca Knapp
, Peter Tuerk
, Amanda K. Gilmore
, Carl Lejuez
, Kenneth Ruggiero
, Wendy Muzzy
, Leonard Egede
, Melba A. Hernandez-Tejada
, Edna B. Foa

Medicine

Department of Veterans Affairs
Medical University of South Carolina
University of Kansas
University of Pennsylvania

Research output: Contribution to journal › Article › peer-review

171 Scopus citations

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.

Original language	English
Pages (from-to)	57-65
Number of pages	9
Journal	Behaviour Research and Therapy
Volume	89
DOIs	https://doi.org/10.1016/j.brat.2016.11.009
State	Published - Feb 1 2017

Keywords

Non-inferiority
Prolonged exposure
PTSD
RCT
Telehealth

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10.1016/j.brat.2016.11.009

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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.",

keywords = "Non-inferiority, Prolonged exposure, PTSD, RCT, Telehealth",

author = "Ron Acierno and Rebecca Knapp and Peter Tuerk and Gilmore, \{Amanda K.\} and Carl Lejuez and Kenneth Ruggiero and Wendy Muzzy and Leonard Egede and Hernandez-Tejada, \{Melba A.\} and Foa, \{Edna B.\}",

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AU - Tuerk, Peter

AU - Gilmore, Amanda K.

AU - Lejuez, Carl

AU - Ruggiero, Kenneth

AU - Muzzy, Wendy

AU - Egede, Leonard

AU - Hernandez-Tejada, Melba A.

AU - Foa, Edna B.

PY - 2017/2/1

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N2 - 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.

AB - 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.

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KW - Prolonged exposure

KW - PTSD

KW - RCT

KW - Telehealth

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JO - Behaviour Research and Therapy

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ER -

A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth

Abstract

Keywords

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