solidersWhat is the best way to treat post-traumatic stress disorder (PTSD)? It depends who you ask. Research from the University of Washington (UW) finds that when PTSD patients select their own treatment, the care is less expensive and more effective. This study is one of the first to examine the costs of PTSD treatments and how patient preferences affect treatment outcomes. The findings could impact how large health care systems, like the United States Department of Veterans Affairs, treat PTSD.

Randomized clinical trials are considered the best research method for many studies, but for investigating the effects of patients’ treatment preferences, the research team had to use another strategy. They devised a method called “doubly randomized preference trial,” which allowed the researchers to isolate the effects of patients’ choices.

Two-thousand people diagnosed with PTSD, aged 18 to 65, participated in the study. Each participant was assigned to either a group that was able to select their preferred treatment or to a group that had treatments selected for them. The participants received 10 weeks of treatment with either the drug sertraline (an anti-depressant) or with a form of counseling called “prolonged exposure therapy.”

For patients who received their preferred treatment, the total annual cost was an average of $6,156 per patient, compared to $7,778 per patient for those who were assigned treatments, representing a savings of $1,622 on average for patients who got their preferred treatment. When patients did not choose their own treatments, prolonged exposure therapy was cheaper than using medication by an average of $1,620 per patient per year. The costs included therapy, hospitalization, and pharmacy services, among others.

Making people with PTSD aware of alternative treatments like yoga, mindfulness training, or other therapy programs could ensure that people with PTSD can select the right treatment for their needs, which improves their quality of life.

“In evaluating how well a treatment works, we seldom pay attention to the role of a patient’s preference, although it could be particularly important in mental health treatments. Trauma survivors … may experience greater relief when they receive the treatment that they prefer,” concluded Lori Zoellner, study co-author and direct of UW’s Center for Anxiety and Traumatic Stress.

This research is published in the Journal of Clinical Psychiatry.

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