Background: Trauma-focused psychotherapies for combat-related posttraumatic stress disorder (PTSD) in military veterans are efficacious, but there are many barriers to receiving treatment. The objective of this study was to determine if cognitive processing therapy (CPT) for PTSD among active duty military personnel and veterans would result in increased acceptability, fewer dropouts, and better outcomes when delivered In-Home or by Telehealth as compared to In-Office treatment.
Methods: The trial used an equipoise-stratified randomization design in which participants (N = 120) could decline none or any 1 arm of the study and were then randomized equally to 1 of the remaining arms. Therapists delivered CPT in 12 sessions lasting 60-min each. Self-reported PTSD symptoms on the PTSD Checklist for DSM-5 (PCL-5) served as the primary outcome.
Results: Over half of the participants (57%) declined 1 treatment arm. Telehealth was the most acceptable and least often refused delivery format (17%), followed by In-Office (29%), and In-Home (54%); these differences were significant (p = 0.0008). Significant reductions in PTSD symptoms occurred with all treatment formats (p < .0001). Improvement on the PCL-5 was about twice as large in the In-Home (d = 2.1) and Telehealth (d = 2.0) formats than In-Office (d = 1.3); those differences were statistically large and significant (d = 0.8, 0.7 and p = 0.009, 0.014, respectively). There were no significant differences between In-Home and Telehealth outcomes (p = 0.77, d = -.08). Dropout from treatment was numerically lowest when therapy was delivered In-Home (25%) compared to Telehealth (34%) and In-Office (43%), but these differences were not statistically significant.
Conclusions: CPT delivered by telehealth is an efficient and effective treatment modality for PTSD, especially considering in-person restrictions resulting from COVID-19.
Trial Registration: ClinicalTrials.gov ID NCT02290847 (Registered 13/08/2014; First Posted Date 14/11/2014).
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8763446 | PMC |
http://dx.doi.org/10.1186/s12888-022-03699-4 | DOI Listing |
Historically, in-person contact between patients and nurses in home-based care has been pivotal in palliative care and hospice care. The provision of home-based palliative care services could be challenged by the projected increase in patients who need palliative care and by the expected shortage of nurses. Digital health services could constitute one measure for delivering high-quality palliative care, enabling patients to stay home.
View Article and Find Full Text PDFJ Clin Med
December 2024
IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy.
Despite the increase in home-based rehabilitation, outcome measures for telerehabilitation are still underdeveloped. The Fugl-Meyer Assessment (FMA) is one of the most widely used tools for evaluating post-stroke motor deficits, with the upper extremity component (FMA-UE) recommended for assessing motor deficits of the arm. This study aims to examine the intrarater and interrater reliability of the Italian version of the FMA-UE, administered remotely via video conferencing during a robotic telerehabilitation program.
View Article and Find Full Text PDFJMIR Med Inform
December 2024
Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect 4, Taichung, 407219, Taiwan, 886 4-2359-2525, 886 4-2359-5046.
Background: Telehealth programs and wearable sensors that enable patients to monitor their vital signs have expanded due to the COVID-19 pandemic. The electronic National Early Warning Score (e-NEWS) system helps identify and respond to acute illness.
Objective: This study aimed to implement and evaluate a comprehensive telehealth system to monitor vital signs using e-NEWS for patients receiving integrated home-based medical care (iHBMC).
J Alzheimers Dis
December 2024
Neurology Unit, Department of Neurosciences, Azienda Ospedaliera Universitaria Integrata, Verona VR, Italy.
Background: Tele-neuropsychology has already been employed in neurocognitive disorders, however, in Italy, the evidence of its psychometric quality and satisfaction is still limited.
Objective: This study aimed to: (1) evaluate the reliability of a standardized battery of neuropsychological screening and domain-specific tests delivered at home via videoconference to a sample of Italian people with cognitive disorders, compared with traditional face-to-face administration; (2) assess the feasibility and satisfaction about remote administration.
Methods: This crossover study enrolled patients with subjective cognitive disorder, mild neurocognitive disorder, or dementia.
JMIR Biomed Eng
December 2024
Department of Biomedical Informatics, School of Medicine, University of Utah, Salt Lake City, UT, United States.
Background: Exercise is essential for physical rehabilitation, helping to improve functional performance and manage chronic conditions. Telerehabilitation offers an innovative way to deliver personalized exercise programs remotely, enhancing patient adherence and clinical outcomes. The Home Automated Telemanagement (HAT) System, integrated with the interactive bike (iBikE) system, was designed to support home-based rehabilitation by providing patients with individualized exercise programs that can be monitored remotely by a clinical rehabilitation team.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!