Abstract
BACKGROUND: Post-traumatic stress disorder (PTSD) affects approximately 1 in 20 individuals, with primary care playing a crucial role in early identification and management. However, PTSD is frequently underdiagnosed in primary care settings. The COVID-19 pandemic has exacerbated the incidence of PTSD, leading to an increased demand for accessible mental health services. While NICE guidelines recommend trauma-focused therapies, access remains limited, underscoring the need for alternative strategies to support management within primary care. AIM: To optimise and refine through co-production the PTSD Hub app, an existing digital resource, to better support individuals with PTSD in primary care settings, improving usability, clinician engagement, and patient outcomes. DESIGN & SETTING: A co-production approach was employed with stakeholders, including people with lived experience of PTSD, informal carers, and primary care professionals. Workshops were held online to gather insights on how to enhance the PTSD Hub app for better integration into primary care. METHOD: Two Nominal Group Technique workshops were conducted to identify key barriers to PTSD care in primary care and generate solutions for improving the app. Participants ranked and prioritised features based on relevance to primary care. RESULTS: Twenty-six participants attended the workshops, representing a diverse mix of stakeholders. Key barriers identified included stigma, clinician time constraints, and limited access to trauma-focused therapies. Solutions included improving symptom tracking, enhancing customisation features, and raising clinician awareness. CONCLUSION: The study highlights the potential of the PTSD Hub app in improving and supporting PTSD management in primary care. Future research should evaluate the app's effectiveness in real-world primary care settings. PATIENT AND PUBLIC CONTRIBUTION: Patients and members of the public were actively involved throughout this study using a co-production approach. A lived experience advisory panel of six individuals with PTSD provided input at all stages, including shaping the study design, reviewing participant materials, and advising on workshop facilitation. Additionally, 26 participants, comprising individuals with lived experience of PTSD, informal carers, and healthcare professionals, contributed to two Nominal Group Technique workshops. A lived experience research partner (NC) was an integral part of the research team, attended all team meetings, co-facilitated workshop sessions and contributed to design, analysis and manuscript preparation.