After initial meetings with ASPE and NIMH to discuss priority measurement areas within the broad field of PTSD care and target populations for this quality measure development effort, we conducted a scan of research literature and clinical guidelines to identify evidence-based treatments for PTSD. The scan drew on systematic reviews (including meta-analyses), primary research studies, evidence-based clinical guidelines, and the recommendations of taskforces, including the Institute of Medicine's taskforce on the treatment of PTSD (Institute of Medicine 2008, 2012).
|TABLE II.1. Sources for Environmental Scan of PTSD Research Studies, Clinical Guidelines, and Quality Measures|
|Source of Information||Data Sources||Selected Search Terms|
||PTSD, trauma, psychotherapy, medication, drugs, pharmacotherapy, treatment, care, services|
||Psychology, psychiatry, adult and trauma, anxiety disorders, stress|
||Mental, behavioral, psychiatry, psychology, PTSD, trauma, anxiety, depression, substance, and patient experience, diabetes, cardiovascular|
To identify relevant studies and guidelines, we developed search terms to guide this information gathering effort and identified data sources for the information (see Table II.1). We limited the scan to studies and guidelines in English and related to the treatment of PTSD in adults. We created detailed Excel spreadsheets with summaries of the treatment or intervention, the outcome measure(s), the results, and the study design and grading of the study design. We used this information to identify evidence-based treatments for adults with PTSD for which there was the strongest scientific evidence. Briefly, the results of the environmental scan identified strong evidence in support of the effectiveness of cognitive behavioral therapy (CBT), particularly exposure therapies, in the treatment of adults with PTSD. The scan also found clinical guideline support for -- but conflicting interpretations of -- the research on the effectiveness of selective serotonin reuptake inhibitors (SSRIs) and insufficient research evidence in adults with PTSD regarding the effectiveness of support services and care coordination (see Appendix A and the Institute of Medicine 2008, 2012).