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2015 HSR&D/QUERI National Conference Abstract

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3110 — A Randomized Controlled Clinical Trial of a Patient Decision Aid for Posttraumatic Stress Disorder

Watts BV, White River Junction VA; Schnurr PP, National Center for PTSD;

Objectives:
Patient decision aids have been used in many clinical situations to improve the patient-centeredness of care. No patient decision aid has been developed or tested in patients with posttraumatic stress disorder (PTSD). Our objective is to evaluate the effects of a patient decision aid on the patient-centeredness of PTSD treatment.

Methods:
The study was a randomized trial of a patient decision aid for individuals with PTSD versus treatment as usual among patients newly diagnosed with PTSD. The participants were 132 male and female veterans presenting to a single VA hospital with a new diagnosis of PTSD. Patient-centeredness was assessed in terms of participant knowledge about PTSD and its treatment, level of decisional uncertainty, and ability to state a preferred treatment option. Secondary outcomes include treatments actually received in the six months after study entry and PTSD symptom outcomes.

Results:
Compared to controls, participants who reviewed the patient decision aid had higher PTSD knowledge (p = 0.002) and less conflict about their choice of treatment (p < = 0.003). In addition, those who reviewed the patient decision aid were more likely to select and receive an evidence-based treatment for PTSD (p = 0.04), and had superior PTSD outcomes (p = 0.004).

Implications:
Use of a patient decision aid was associated with improvements in patient-centered PTSD treatment. The patient decision aid was also associated with greater use of evidence-based treatments and improved PTSD symptom outcomes. This study suggests that use of the patient decision aid for PTSD should be considered in clinics seeing patients with PTSD.

Impacts:
Increased used of patient decision aids should be considered in Veterans with PTSD to improve the overall quality of care they receive.