A - 169 Efficacy, Retention and Predictors of Response to Treatment of Group Based Remotely Delivered Goal Management Training for Acquired Brain Injury.

Abstract

Given the gap in group-based, remotely delivered executive interventions, and the ubiquitousness of executive impairment in acquired brain injury (ABI), we examined: (1) pre-to-post-to-follow-up efficacy of remotely-delivered, group-based Goal Management Training (GMT; a metacognitive, executive intervention) in individuals with neurological disorders in the chronic stages of illness (2) predictors of response to treatment. Participants and Protocol. N = 160 adults with ABI >6months post-diagnosis, participated in this single-group study at the Telerehab Centre for ABI @KITE, University Health Network, Toronto, Canada. GMT - which enhances self-awareness, task engagement and task follow-through - was delivered remotely and in group format to allow scalability, peer-to-peer support, cost-effectiveness, and geographical reach. Primary outcomes. Cognitive Failures Questionnaire (CFQ); Dysexecutive Questionnaire (DEX). Predictors of response to treatment. Demographics (age, education); time since injury; and symptom burden (i.e., cognitive, somatic, and emotional). Linear mixed effects models measured efficacy and predictors of change. Significant pre/post and pre/follow-up improvements on the CFQ total and "forget", "false", and "distract" subscales (95% CI; p = 0.000 all comparisons). Significant pre/post improvements observed for the DEX (95% CI; p = 0.000), but not significant retention. No effects of age, education or time since injury found, indicating generalizability. High symptom burden negatively associated with pre/post and pre/ follow-up improvements on CFQ. Encouragingly, this group-based, remotely delivered GMT offers promise of efficacy and retention regardless of age, time since injury or educational attainment of patients, and can reach patients regardless of geographic location. Lower response with heavy symptom burden suggests collateral treatment of symptoms may improve treatment response.