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Care models including patient trauma history improve health outcomes

A trauma-informed primary care model addressing the impact of trauma on health behaviors and outcomes, may improve both patient and provider experiences, according to a commentary recently published in Women’s Health Issues.

“Understanding the link between trauma and heath is an epiphany for clinicians,” Edward L. Machtinger, MD, director of the Women’s HIV Program at University of California San Francisco said in a press release. “Many of us have spent years struggling to help our patients improve their healthy but did not realize that there was a missing ingredient in our model off care. Trauma affects health not only through psychological and behavioral factors, but also biologically, through neuroendocrine and inflammatory changes in response to trauma. By understanding the central role that trauma plays in illness, we can use this new model to reengineer clinical practice around trauma-informed principles to better serve our patients and save lives.”

To develop their trauma-informed primary care (TIPC) model, Machtinger and colleagues convened a national strategy group to review existing strategies and frameworks, which guided the model’s development. Their method, which is intended to ease trauma-related triggers and stimulate healing, encompasses four key components; environment, screening, response and an organizational foundation.

The environment within the TIPC model aims to empower both patients and providers. All staff within a primary care practice receive training regarding the influence of trauma on health and work with one another to ensure that trauma-informed services are being enforced.

Patients are educated about the association between trauma and health, and regular screening procedures are normal practice. After screening patients for any lifetime trauma and the consequences of such trauma, including PTSD, depression, suicidality, substance abuse and chronic pain, providers then offer trauma-related information and interventions. These approaches are offered whether patients have disclosed their trauma or not. 

When providers respond to patient trauma, they should be compassionate and supportive so as to validate the choices and experiences the patient has made.

The researchers said that incremental implementation is the best approach for health care providers to incorporate TIPC into their practices, noting that full implementation will require sincere commitment.

“At its core, TIPC is good patient-centered care,” Machtinger and colleagues wrote. “Helping women heal from trauma and its consequences will inevitably lead to healthier and less traumatic environments for their children, families and communities…For both patients and providers, moving towards TIPC has the potential to transform the experience and efficacy of primary care from treatment to genuine healing.”. – by Casey Hower

Disclosure: The researchers report no relevant financial disclosures.