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IOM: Effectiveness of PTSD treatments provided by DOD & VA unknown
Date:6/20/2014

he departments have no way of knowing whether the care they are providing is effective or whether DOD and VA's expenditures are resulting in high-value health care, said the committee that wrote the report.

"Given that the DOD and VA are responsible for serving millions of service members, families, and veterans, we found it surprising that no PTSD outcome measures are used consistently to know if these treatments are working or not," said committee chair Sandro Galea, professor and chair of the department of epidemiology, Mailman School of Public Health, Columbia University, New York City. "They could be highly effective, but we won't know unless outcomes are tracked and evaluated." An exception, the committee noted, are VA's specialized intensive PTSD programs, which are collecting outcomes data. Nevertheless, these programs serve only 1 percent of veterans who have PTSD, and the data suggest the programs yield only modest improvements in symptoms.

The report recommends that DOD and VA develop, coordinate, and implement a measurement-based PTSD management system that documents patients' progress over the course of treatment, regardless of where they receive treatment, and does long-term follow-up using standardized and validated instruments. Reliable and valid self-report measures, such as the PTSD Checklist, are available and could be used to monitor patient progress and guide modifications of individual treatment plans.

Current DOD and VA strategic efforts do not necessarily encourage the use of best practices for preventing, screening for, diagnosing, and treating PTSD, the committee observed. In DOD and the service branches, leaders at all levels are not consistently held accountable for implementing policies and programs to manage PTSD effectively. And although the VA's central office has established policies on minimum care requirements and guidance on PTSD treatment, it is unclear whether VA leaders adhere to the policies, enc
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Contact: Jennifer Walsh
news@nas.edu
202-334-2138
National Academy of Sciences
Source:Eurekalert

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