Evidence map›Paper›PMID 30966944›Full record

Observational studyPsychiatric services (Washington, D.C.)2019

Adoption by VA Residential Programs of Two Evidence-Based Psychotherapies for PTSD: Effect on Patient Outcomes.

Joan M Cook, Paula P Schnurr, Vanessa Simiola, Richard Thompson, Rani Hoff, Ilan Harpaz-Rotem

Abstract readObservational Study
In one paragraph

Observational study in Psychiatric services (Washington, D.C.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Joan M CookDepartment of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Cook, Hoff, Harpaz-Rotem); National Center for PTSD, U.S. Department of Veterans Affairs (VA) Connecticut Healthcare System, West Haven (Cook, Hoff, Harpaz-Rotem); National Center for PTSD, White River Junction VA Medical Center, White River Junction, Vermont (Schnurr); Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (Schnurr); Center for Health Research, Kaiser Permanente, Honolulu (Simiola).
Paula P SchnurrDepartment of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Cook, Hoff, Harpaz-Rotem); National Center for PTSD, U.S. Department of Veterans Affairs (VA) Connecticut Healthcare System, West Haven (Cook, Hoff, Harpaz-Rotem); National Center for PTSD, White River Junction VA Medical Center, White River Junction, Vermont (Schnurr); Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (Schnurr); Center for Health Research, Kaiser Permanente, Honolulu (Simiola).
Vanessa SimiolaDepartment of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Cook, Hoff, Harpaz-Rotem); National Center for PTSD, U.S. Department of Veterans Affairs (VA) Connecticut Healthcare System, West Haven (Cook, Hoff, Harpaz-Rotem); National Center for PTSD, White River Junction VA Medical Center, White River Junction, Vermont (Schnurr); Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (Schnurr); Center for Health Research, Kaiser Permanente, Honolulu (Simiola).
Richard ThompsonDepartment of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Cook, Hoff, Harpaz-Rotem); National Center for PTSD, U.S. Department of Veterans Affairs (VA) Connecticut Healthcare System, West Haven (Cook, Hoff, Harpaz-Rotem); National Center for PTSD, White River Junction VA Medical Center, White River Junction, Vermont (Schnurr); Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (Schnurr); Center for Health Research, Kaiser Permanente, Honolulu (Simiola).
Rani HoffDepartment of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Cook, Hoff, Harpaz-Rotem); National Center for PTSD, U.S. Department of Veterans Affairs (VA) Connecticut Healthcare System, West Haven (Cook, Hoff, Harpaz-Rotem); National Center for PTSD, White River Junction VA Medical Center, White River Junction, Vermont (Schnurr); Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (Schnurr); Center for Health Research, Kaiser Permanente, Honolulu (Simiola).
Ilan Harpaz-RotemDepartment of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Cook, Hoff, Harpaz-Rotem); National Center for PTSD, U.S. Department of Veterans Affairs (VA) Connecticut Healthcare System, West Haven (Cook, Hoff, Harpaz-Rotem); National Center for PTSD, White River Junction VA Medical Center, White River Junction, Vermont (Schnurr); Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (Schnurr); Center for Health Research, Kaiser Permanente, Honolulu (Simiola).

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Sustained Use of Evidence-Based PSTD Treatment in VA Residential SettingsR01MH096810 · NIMH · YALE UNIVERSITY · PI COOK, JOAN M · 2012 to 2015
$1.6M
NCATS NIH HHS UL1 TR001863NIMH NIH HHS R01 MH096810
6 · The paper itself

Abstract

objectiveThis observational study examined the association between patient outcomes at 39 U.S. Department of Veterans Affairs residential treatment programs for veterans with posttraumatic stress disorder (PTSD) and the degree of adoption of two evidence-based psychotherapies, prolonged exposure and cognitive processing therapy. The hypothesis was that a higher degree of adoption would be associated with better outcomes.

methodsProviders (N=171) completed a qualitative interview and quantitative survey about their level of adoption of prolonged exposure delivered individually and cognitive processing therapy delivered in individual or group formats. On the basis of responses, programs were assigned to one of three adoption categories: little or no adoption of either therapy (N=8), some adoption, (N=9), and high adoption (N=22). A linear mixed model compared patient outcomes (e.g., PTSD and depression symptom severity, substance use, and distress) between adoption groups.

resultsThe sample of veterans consisted of 2,834 who completed an assessment of PTSD symptoms and functioning at program intake and again at either program discharge or at 4 months postdischarge. Improvements in PTSD, distress, and alcohol use were noted over time for all programs, with decreases at follow-up. No effects of adoption group or a group × time interaction were noted for any outcome.

conclusionsModerate to large effects were noted across all programs. However, programs that used prolonged exposure and cognitive processing therapy with most or all patients did not see greater reductions in PTSD or depression symptoms or alcohol use, compared with programs that did not use these evidence-based psychotherapies.

Indexed as

Outcome and Process Assessment, Health CareVeteransAdultCognitive Behavioral TherapyComorbidityDepressionFemaleHumansImplosive TherapyMaleMiddle AgedPsychological DistressResidential TreatmentStress Disorders, Post-TraumaticSubstance-Related DisordersUnited StatesAdoptionPosttraumatic stress disorder (PTSD)

Identifiers

PMID30966944
PMCPMC6690369

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.