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Telemedicine may help rural Veterans with PTSD

A study published in the Nov. 19, 2014, issue of JAMA Psychiatry titled "Telemedicine-based collaborative care for posttraumatic stress disorder: a randomized clinical trial" received considerable coverage in national and local news outlets, including Reuters Health.

The study concluded that telemedicine-based care delivered at community-based outpatient clinics (CBOCs) can successfully engage rural Veterans in evidence-based psychotherapy, and that such care improves PTSD outcomes. Lead author Dr. John Fortney of the VA Puget Sound Health Care system in Seattle was interviewed by Reuters Health about the study.

"We know that 38 percent of VA patients diagnosed with PTSD live in rural areas, and that two-thirds live closer to one of VA's 825 CBOCs than to a large medical center, which underscores the importance of striving to provide the highest quality PTSD care in these clinics," said Fortney.

For the study, investigators looked at 265 middle-aged Veterans with severe PTSD symptoms being treated at CBOCs in Shreveport, La.; Little Rock, Ark.; and Loma Linda, Calif. Half of the patients received ordinary care at the CBOCs, and the other half were connected to care at VA medical centers via telehealth techniques such as videoconferencing.

About 55 percent of the patients (73 of 133) in the telemedicine received cognitive processing therapy, compared with only 12 percent of those in the usual care group. Cognitive processing therapy is of one of two main types of evidence-based psychotherapy that is promoted in VA. Patients in the telemedicine group also had significantly larger decreases in PTSD severity.

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