Clemens Scott Kruse, James M. Atkins, Tiffany D. Baker, Estefania N. Gonzales, Jennifer L. Paul, Matthew Brooks
School of Health Administration, Texas State University, 78666 San Marcos, USA. E-mail: scottkruse@txstate.edu
DOI: 10.2340/16501977-2302

Background: Military veterans returning from a combat zone often face mental health challenges as a result of traumatic experiences. The veteran in the United States has been underdiagnosed and underserved. Since its advancement in the 1990s, telemedicine has become a more prevalent means of delivering services for post-traumatic stress disorder among veterans in the United States, but its adoption is not ubiquitous.
Objective: To clarify the association of telemedicine and the treatment of veterans with post-traumatic stress disorder through identification of facilitators and barriers to the adoption of the modality.
Methods: Reviewers analysed articles from CINAHL and PubMed databases, using relative key words, selecting the 28 most germane to the study objective.
Results: The most common adoption facilitators were: improving access to rural populations of veterans (22%), effective treatment outcomes (16%), and decreased costs related to care (13%). The most prevalent barriers were: veterans lacking access to necessary modalities (25%), availability of physicians competent in post-traumatic stress disorder treatment (20%), and complications with technology (20%). Five themes surfaced for facilitators: accessibility, effectiveness, cost reduction, positive patient perception, and supportive community; and 5 themes for barriers: access to technology, technical complications, physician availability, negative patient perception, and uninformed patients.
Conclusion: This literature review identifies cost and outcomes-effectiveness. The association of telemedicine with the treatment of veterans with post-traumatic stress disorder is feasible, beneficial and effective.

Veterans continue to face mental-illness challenges upon returning from a combat zone as a result of traumatic experiences. We therefore studied the use of telemedicine as a viable means to treat veterans with PTSD. Telemedicine, as a modality of care, extends access to rural communities and to those with either mobility or travel restrictions. This systematic review analyzed 28 studies and found that the use of telemedicine to treat PTSD improved access, resulted in equally effective treatment outcomes, and decreased costs related to care. Physicians should seek this modality when seeking to extend their boundaries of access without expanding their clinic space, but additional training of staff will be required.

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