Increasing engagement in evidence-based PTSD treatment through shared decision-making: a pilot study

Area of Science:

• Mental Health
• Clinical Psychology
• Health Services Research

Background:

• Treatment decisions for post-traumatic stress disorder (PTSD) within the Veterans Health Administration lack standardization, leading to variable patient engagement.
• Shared decision-making (SDM) interventions offer a structured approach to enhance patient and provider collaboration in treatment planning.
• Improving engagement in evidence-based PTSD treatments is crucial for optimizing veteran care outcomes.

Purpose of the Study:

• To develop a brief shared decision-making (SDM) intervention for post-traumatic stress disorder (PTSD) treatment.
• To pilot test the feasibility and potential effectiveness of this SDM intervention in promoting engagement with evidence-based PTSD care.
• To assess the impact of the SDM intervention on treatment preference and adequate treatment dosage.

Main Methods:

• Phase 1 involved developing an initial SDM intervention, refined through stakeholder feedback.
• Phase 2 was a pilot randomized trial with 27 Iraq and Afghanistan Veterans at a VA PTSD clinic.
• Participants received either the 30-minute SDM intervention or usual care during intake.

Main Results:

• A higher proportion of participants in the SDM intervention group preferred evidence-based post-traumatic stress disorder (PTSD) treatments compared to usual care.
• Veterans in the SDM intervention group were more likely to receive an adequate dose (≥9 sessions) of psychotherapy.
• The intervention demonstrated preliminary feasibility and potential effectiveness in enhancing engagement with PTSD care.

Conclusions:

• The brief shared decision-making (SDM) intervention appears feasible and potentially effective for improving engagement in evidence-based post-traumatic stress disorder (PTSD) treatment among Veterans.
• Findings support the need for larger-scale trials to further validate the SDM intervention's efficacy.
• Standardized SDM approaches may enhance treatment adherence and outcomes in PTSD care within the Veterans Health Administration.