An effectiveness-implementation hybrid trial study protocol targeting posttraumatic stress disorder and comorbidity

Douglas F. Zatzick; Joan Russo; Doyanne Darnell; David A. Chambers; Lawrence Palinkas; Erik Van Eaton; Jin Wang; Leah M. Ingraham; Roxanne Guiney; Patrick Heagerty; Bryan Comstock; Lauren K. Whiteside; Gregory Jurkovich

doi:10.1186/s13012-016-0424-4

Implementation Science

Table 1 Core elements of collaborative care intervention targeting PTSD and comorbidity after injury

From: An effectiveness-implementation hybrid trial study protocol targeting posttraumatic stress disorder and comorbidity

Essential element	Which disorders targeted	MCC strategic framework goals addressed^a
Population-based EHR PTSD and comorbidity risk prediction	PTSD, depression, suicidal ideation, alcohol and drug use problems, TBI and chronic medical conditions after acute injury	Goal 1 objective D implement and efficiently use health information technology; EHR screening efficiently identifies constellation of PTSD and comorbidity in injured populations
Care management with trauma center to primary care linkage	Coordination of acute injury mental health and pre-existing chronic medical condition care	Goal 2 facilitate use of community based services and self-care management
Early post-injury medication history, reconciliation, and care coordination	PTSD, depression, pain, and TBI symptoms prevention. Chronic medical condition reconciliation and coordination	Goal 1 objective E prevent occurrence of new chronic conditions and mitigate the consequences of existing conditions
		Goal 2 objective C provide tools for medication management
Evidence-based MI embedded within care management	Targets alcohol and drug use problems and enhanced patient engagement	Goal 1 objective E prevent occurrence of new chronic conditions and mitigate the consequences of existing conditions
Evidence-based CBT embedded within care management	Targets PTSD, depression, pain, and TBI symptoms. Also targets enhanced patient self-efficacy	Goal 1 objective E prevent occurrence of new chronic conditions and mitigate the consequences of existing conditions
Evidence-based CBT embedded within care management		Goal 2 objective A facilitate self-care management
Patient and caregiver-centered posttraumatic concern elicitation and improvement	Patient-centered concerns elicitation and improvement targets patient and family engagement in care of full MCC constellation	Goal 2 optimize self-care management and coordinated use of services by patient and caregivers
Caseload supervision and stepped measurement-based care implementation	PTSD, depression and associated suicidal ideation, alcohol and drug use problems, chronic medical conditions and acute physical injury	Goal 3 provide better information and education on treatment of MCCs to health care workers

MCC multiple chronic condition, EHR electronic health record, PTSD posttraumatic stress disorder, TBI traumatic brain injury, MI motivational interviewing, CBT cognitive behavioral therapy
^aAll study elements address MCC Goal 4 of Enhancing Research Knowledge on MCCs [17–19]

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