Giving Patients Treatment Choice Improves PTSD Outcomes
FRIDAY, Oct. 26, 2018 -- Giving patients with post-traumatic stress disorder (PTSD) their preferred treatment improves adherence and symptoms, according to a study published online Oct. 19 in The American Journal of Psychiatry.
Lori A. Zoellner, Ph.D., from the University of Washington in Seattle, and colleagues randomly assigned 200 patients with PTSD to choice of treatment or no choice. Those assigned to no choice were then randomly assigned to prolonged exposure or sertraline. Acute treatment lasted 10 weeks, and follow-up took place over 24 months.
The researchers found that patients preferred prolonged exposure over sertraline (number needed to benefit [NNTB], 4.5). In intent-to-treat analyses, both prolonged exposure and sertraline showed substantial benefits that were maintained during the follow-up period. There was no differential effect on interviewer-rated PTSD severity, but there was a significant benefit of prolonged exposure over sertraline on interview-rated loss of PTSD diagnosis (NNTB, 7); responder status (NNTB, 5.7); and self-reported PTSD, depression, and anxiety symptoms and functioning (effect sizes, 0.35 to 0.44). Participants receiving their preferred treatment were more likely to be adherent; lose their PTSD diagnosis (NNTB, 3.4); achieve responder status (NNTB, 3.4); and have lower self-reported PTSD, depression, and anxiety symptoms (effect sizes, 0.4 to 0.72).
"To better personalize PTSD care, we must understand the impact of preferences on empirically supported interventions," the authors write.
Pfizer supplied the study medication, and one author disclosed ties to Valent Medical Solutions.
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Posted: October 2018