A research team led by John Fortney, PhD, has received a $6.9 million funding award from the Patient-Centered Outcomes Research Institute (PCORI) to study the effectiveness of using commonly prescribed antidepressants and brief exposure-based therapies to treat Posttraumatic Stress Disorder (PTSD) in primary care. Results will help patients and primary care providers choose which treatment to try first and which treatment to try second if the first is not effective.

“I am particularly excited about this trial because I get to collaborate with both my VA colleagues and my university colleagues,” says John. “I am also pleased I will be able to continue working with many of the consumer stakeholders that are participating in our currently-funded PCORI SPIRIT trial.”

Research shows that individuals with PTSD are more likely to engage in unhealthy behaviors, such as tobacco use, drug use, and alcohol misuse, and have high rates of morbidity/mortality. PTSD negatively impacts families, educational attainment, and occupational functioning. Many patients with PTSD do not engage in specialty mental health care because of geographical, financial, or cultural barriers and improving the availability of effective treatments in primary care settings has tremendous potential to improve access to care and outcomes for millions of individuals living with PTSD.

There are no head-to-head comparisons between pharmacotherapy and psychotherapy in primary care settings, and primary care providers often do not know which treatments to recommend to their patients. In addition, despite high treatment nonresponse rates, very few studies have examined which treatment should be recommend next when patients do not respond well to the first option. The trial will be conducted in Federally Qualified Health Centers and Veterans Affairs Medical Centers, where the prevalence of both past trauma exposure and PTSD are particularly high. It will enroll 1,500 primary care patients.