IT Enhanced Peer Integrated Collaborative Care for US Trauma Care Systems

NCT03569878 | Completed Results DMC

• 1 other identifier: STUDY00005068
• Study Type: interventional
• Target: 450
• Locations: 1 country
• Sites: 1

Brief Summary

This study evaluates two readily implementable approaches to the delivery of transitional care for injured patients treated emergently in US trauma care systems. The two approaches to be compared are a multidisciplinary team collaborative care intervention that integrates front-line trauma center staff with peer interventionists to trauma surgical team notification of patient emotional distress with recommended mental health consultation. The collaborative care intervention will be supported by a novel Emergency Department (ED) health information exchange technology platform.

Conditions

PTSD; Physical Injury

Keywords

PTSD; Physical Injury; Patient Concerns; Emergency Department Utilization

Outcome Measures

Primary Outcomes (4)

• Number of Patients With 1 or More Emergency Department Visits Per Quarter

  Number of emergency visits will be assessed using the Emergency Department Information Exchange (EDIE). More emergency visits are indicative of a worse outcome.

  Baseline injury admission to 12-months post-injury follow-up

• Change in Posttraumatic Concern Severity

  The severity of patient described post-injury concerns as rated by patients on a 1 through 5 scale; 1 being not at all concerning and 5 being extremely concerning. Higher scores are indicative of a worse outcome. The concern outcome can either be represented as a mean severity score or as a percentage of patients with one or more severe concerns.

  Baseline injury admission and 1-, 3-, 6-, 9- and 12-months post-injury follow-up

• Change in Posttraumatic Stress Disorder (PTSD) Symptoms

  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.

  Baseline injury admission and 1-, 3-, 6-, 9- and 12-months post-injury follow-up

• Change in Functional Status

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

  Baseline injury admission and 1-, 3-, 6-, 9- and 12-months post-injury follow-up

Study Arms (2)

Peer-Integrated Multidisciplinary Collaborative Care

EXPERIMENTAL

The peer-integrated collaborative care intervention includes front-line trauma center staff (e.g., nursing and masters in social work), joined by injured peer interventionists and supervised by an MD (psychiatrist). The collaborative care team will provide case management, behavioral intervention elements, psychopharmacologic medication recommendations as well as 24/7 cell phone coverage for approximately 6 months post-injury. The intervention will be supported by a novel emergency department health information technology platform.

Behavioral: Peer-Integrated Multidisciplinary Collaborative Care

Trauma surgery team notification

ACTIVE COMPARATOR

Trauma surgery team notification of patient emotional distress, with recommendation for mental health inpatient consultation will be the comparator condition.

Behavioral: Trauma surgery team notification

Interventions

Peer-Integrated Multidisciplinary Collaborative Care BEHAVIORAL

Case management, behavioral intervention elements, psychopharmacologic medication recommendations and 24/7 cell phone coverage for 6 months post-injury.

Peer-Integrated Multidisciplinary Collaborative Care

Trauma surgery team notification BEHAVIORAL

Trauma surgery team notification of patient emotional distress, with plan for mental health inpatient consultation will be the comparator condition.

Trauma surgery team notification

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Inpatient/emergency admission for intentional and/or unintentional injury
• Score of ≥35 on the PTSD checklist
• Endorsement of ≥ 1 severe posttraumatic concern

You may not qualify if:

• Patients who required immediate psychiatric intervention
• Patients who are not Washington or Oregon State residents
• Patients who are currently incarcerated
• Patients not speaking Spanish or English

Sponsors & Collaborators

• University of Washington: lead
• Patient-Centered Outcomes Research Institute: collaborator

Study Sites (1)

University of Washington Harborview Level I Trauma Center

Seattle, Washington, 98104, United States

Location

Related Publications (4)

• Palinkas LA, Engstrom A, Knutsen T, Walen ML, Whiteside L, Nehra D, Zatzick D. Implementation of a Face-To-Face Vs Virtual Peer-Integrated Collaborative Care Intervention for Mental Health Treatment of Physical Trauma Survivors: A Qualitative Study of Lessons from the COVID-19 Pandemic. Psychiatry. 2025 Nov 25:1-7. doi: 10.1080/00332747.2025.2592725. Online ahead of print.

  PMID: 41289309 DERIVED

• Iles-Shih M, Kelly G, McManamen M, Buggaveeti AE, Bulger E, Ryan P, Conde C, Huynh M, Ahmad M, Russo J, Wang J, Zatzick D. Can screening and referral for posttraumatic stress improve mental health and substance abuse service delivery at trauma centers? Results from a randomized trial. Injury. 2026 Jan;57(1):112845. doi: 10.1016/j.injury.2025.112845. Epub 2025 Oct 25.

  PMID: 41173731 DERIVED

• Zatzick DF, Bulger EM, Thomas P, Engstrom A, Iles-Shih M, Russo J, Wang J, Shoyer J, Conde C, Abu K, Birk N, Palinkas L, Heagerty P, Whiteside LK, Ryan P, Knutzen T, Maier R. Randomized clinical trial of peer integrated collaborative care intervention after physical injury. Trauma Surg Acute Care Open. 2025 Jan 19;10(1):e001657. doi: 10.1136/tsaco-2024-001657. eCollection 2025.

  PMID: 39845998 DERIVED

• Scheuer H, Engstrom A, Thomas P, Moodliar R, Moloney K, Walen ML, Johnson P, Seo S, Vaziri N, Martinez A, Maier R, Russo J, Sieber S, Anziano P, Anderson K, Bulger E, Whiteside L, Heagerty P, Palinkas L, Zatzick D. A comparative effectiveness trial of an information technology enhanced peer-integrated collaborative care intervention versus enhanced usual care for US trauma care systems: Clinical study protocol. Contemp Clin Trials. 2020 Apr;91:105970. doi: 10.1016/j.cct.2020.105970. Epub 2020 Feb 29.

  PMID: 32119926 DERIVED

MeSH Terms

Conditions

Stress Disorders, Post-Traumatic

Condition Hierarchy (Ancestors)

Stress Disorders, Traumatic; Trauma and Stressor Related Disorders; Mental Disorders

Results Point of Contact

• Title: Douglas Zatzick
• Organization: Department of Psychiatry, University of Washington School of Medicine

dzatzick@uw.edu

206 744-6701

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor, School of Medicine: Psychiatry, Clinical

Study Record Dates

• First Submitted: June 15, 2018
• First Posted: June 26, 2018
• Study Start: August 6, 2018
• Primary Completion: July 11, 2023
• Study Completion: June 12, 2024
• Last Updated: October 26, 2024
• Results First Posted: October 15, 2024

Record last verified: 2024-10

Locations

US (1)