Health Services Research & Development

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2007 HSR&D National Meeting Abstract

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National Meeting 2007

2013 — Preventing Chronicity and Relapse in SUD/PTSD: Research Issues

Weaver C (Center for Health Care Evaluation) , Crawford E (National Center for PTSD), DeBenedetti A (Center for Health Care Evaluation), Rosen C (Center for Health Care Evaluation), McKellar J (Center for Health Care Evaluation), Timko C (Center for Health Care Evaluation), Trafton JA (Center for Health Care Evaluation), Kimerling R (National Center for PTSD)

Workshop Objectives:
Maintaining treatment gains following intensive care is key to long-term recovery from chronic disorders, however, research into effective health care strategies to prevent relapse is in its early stages. Various strategies to encourage maintenance of health behaviors may be envisioned, including targeting relapse risk factors during intensive treatments, utilizing technologies to increase contact with patients following intensive care, or empowering patients to utilize community resources to sustain recovery. This workshop will explore clinical challenges and research issues encountered in developing and testing these three types of innovative programs to improve maintenance of treatment gains in patients with PTSD and/or SUD, two chronic relapsing disorders.

Activities:
We will present methodology used to address common barriers to implementing and assessing effectiveness of programs to prevent relapse following intensive treatment. Four recently funded VA HSR&D effectiveness trials will be presented as examples: 1 incorporates treatment for relapse-risk factors into standard SUD treatment, 2 test telehealth interventions to enhance aftercare, and 1 enhances referral of patients to community resources. Specific challenges encountered in designing and implementing these trials will be presented for guided problem-solving discussion in small groups. Techniques for addressing difficulties with assessing low base rate outcomes (e.g. suicide, violence perpetration, hospitalization), preventing loss to follow-up in subjects out of intensive care, determining non-VA treatment received following index care, protecting vulnerable human subjects, determining appropriate control conditions, and assessing effectiveness in important dispersed minority patient populations (e.g. OEF/OIF veterans) will be covered. Solutions chosen in each of the trials and alternatives will be addressed.

Target Audience:
Health Services researchers interested in studying programs for maintaining health improvements following intensive treatment are targeted. The workshop will also be of interest to those designing and implementing intervention trials in general, and those developing interventions to improve mental health recovery.

Assumed Audience Familiarity with Topic:
No familiarity with the concepts presented is assumed.