Characterizing and Comparing Evidence-Based Psychotherapy Utilization Among Veterans with Co-occurring PTSD and...

Area of Science:

• Psychiatry
• Clinical Psychology
• Health Services Research

Background:

• Co-occurring Post-Traumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD) are prevalent among Veterans.
• Evidence-based psychotherapies (EBPs) for PTSD are effective but their completion rates across different SUD subtypes require investigation.
• Understanding treatment completion is crucial for optimizing care for this complex patient population.

Purpose of the Study:

• To describe a national sample of Veterans with co-occurring PTSD and SUD who initiated and completed PTSD EBPs.
• To determine if PTSD EBP completion rates differ based on SUD subtype (alcohol use disorder vs. other SUDs).

Main Methods:

• Utilized Veterans Health Administration electronic health record data for 2,996 Veterans diagnosed with PTSD and SUD.
• Identified patients who initiated Cognitive Processing Therapy (CPT) or Prolonged Exposure (PE) between January 1, 2019, and July 16, 2019.
• Employed logistic regression to compare EBP completion rates between Veterans with alcohol use disorder (AUD) and those with other SUDs.

Main Results:

• The study sample (N=2,996) comprised Veterans with a mean age of 45 years, predominantly male, White, and non-Hispanic.
• Logistic regression analysis showed no significant difference in EBP completion rates between Veterans with AUD and those with other SUDs (OR=1.02, 95% CI=0.87-1.17, p=0.79).

Conclusions:

• Completion rates for PTSD evidence-based psychotherapies did not significantly vary across different substance use disorder subtypes in the studied Veteran population.
• These findings indicate that EBPs for PTSD are generally well-tolerated and can be considered for Veterans with co-occurring PTSD and various SUDs.