Heuristic recommendations to advance knowledge about personalizing PTSD treatment via practice-based research

Area of Science:

• Psychology
• Psychiatry
• Health Services Research

Background:

• Evidence-based psychotherapies (EBPs) have transformed posttraumatic stress disorder (PTSD) treatment.
• Limited options exist for personalizing treatment when EBPs are ineffective or unsuitable.
• There's a gap in utilizing real-world clinical data to inform research on intervention effectiveness and moderators.

Purpose of the Study:

• To review barriers to evidence-based idiographic treatment planning and practice-based research.
• To propose a localized learning healthcare approach for generating continuous, real-world evidence.
• To offer recommendations for advancing this practice-based research paradigm.

Main Methods:

• Literature review of research and clinical context barriers.
• Proposal of a localized learning healthcare model.
• Development of recommendations for implementation and infrastructure enhancement.

Main Results:

• Identified significant barriers in current treatment planning and research generation.
• Proposed a model prioritizing patient and provider needs for continuous evidence generation.
• Outlined recommendations for measurement-based care, including clinical dashboards and flexible assessments.

Conclusions:

• A localized learning healthcare approach can bridge the gap between research and real-world clinical practice for PTSD.
• Enhancing measurement-based care infrastructure is crucial for generating actionable, practice-based evidence.
• The US Department of Veterans Affairs network is well-positioned to lead this new research paradigm.