A Policy Relevant US Trauma Care System Pragmatic Trial for PTSD and Comorbidity Pilot (TSOS6)

실험적: Intervention

The intervention aims to prevent the development of chronic PTSD and depressive symptoms, alcohol use problems, and enduring physical disability in survivors of both TBI and non-TBI injuries. The intervention utilizes a computerized decision support tool to flexibly target these multiple conditions including and includes care management, medication, and psychotherapy elements.

행동: 동기 부여 인터뷰

행동: 인지 행동 치료 요소

의약품: Psychotropic Drugs

다른: Care Management

간섭 없음: Usual Care

Only standard care practices will be administered to this arm.

Change From Baseline PTSD Checklist Civilian (PCL-C) at 1 Month

The investigators will use the PTSD Checklist - Civilian (PCL-C). The scoring of the scale ranges from a minimum of 17 to a maximum of 85, with higher scores indicating a worse outcome. The measure can also provide a rating of symptoms consistent with a diagnosis of PTSD.

Change From Baseline Alcohol Use Disorders Identification at 1 Month

The investigators will use the Alcohol Use Disorders Identification Test (AUDIT) as a continuous measure. The 10-item scale score ranges from 0-40, with higher values indicating a worse outcome.

Change From Patient Health Questionnaire 9 Item Depression Scale at 1 Month

The investigators will use the Patient Health Questionnaire 9-item Depression Scale (PHQ-9). The scoring of the scale ranges from a minimum of 0 to a maximum of 27, with higher scores indicating a worse outcome.

Change in Functional Status

The investigators will use the Medical Outcomes Study Short Form healthy survey (MOS SF-12/36) physical components summary to assess physical function. The minimum and maximum scores are 0-100 with higher scores representing a better outcome.

Patient Health Questionnaire Item 9 Suicide Question

Item 9 of the Patient Health Questionnaire 9-item (PHQ-9) scale assesses suicidal ideation. It is scored from 0 to 3, with a score of 1 or greater indicating a patient has suicidal ideation. Participants with a PHQ-9 item 9 score of greater than or equal to 1 are reported for this outcome.

Number of Participants Endorsing a Single Item That Assesses Drug Use

Single items that assess drug use across multiple substances (e.g., Cocaine, Prescription Opiates). Single item self-report dichotomized as none versus at least monthly use.

Cognitive Impairment Scale

The investigators will use the National Study on the Costs and Outcomes of Trauma (NSCOT) Cognitive Screen, a 4 - Item Traumatic Brain Injury / Post-concussive Symptom Screen. The scoring of the scale ranges from a minimum of 4 to a maximum of 20, with lower scores indicating a worse outcome.

Chronic Medical Condition ICD-9 Definition

Moderating Variable

Traumatic Brain Injury Status ICD-9 Definition

Moderating Variable