Effect of a Combined Cognitive and Vocational Intervention on Change in HRQoL after TBI

Abstract

<h3>Research Objectives</h3> To compare the effect of a combined cognitive and vocational intervention to treatment as usual (TAU) on change in health-related quality of life (HRQoL) after mild-to-moderate traumatic brain injury (TBI). <h3>Design</h3> Randomized controlled trial. <h3>Setting</h3> Specialized TBI outpatient clinic at Oslo University Hospital, Norway. <h3>Participants</h3> 116 patients aged 18-60 years with mild-to-moderate TBI were recruited 8-12 weeks post injury and randomized to the study intervention (n=60) or TAU (n=56). The participants' mean age was 42 years (SD 9.8) and 60% (n = 69) were female. Injury severity was mild in 94% of cases and the most frequent cause of injury were falls (43%). <h3>Interventions</h3> Compensatory Cognitive Training (CCT) and Supported Employment (SE) or multidisciplinary TAU provided for a maximum of six months. <h3>Main Outcome Measures</h3> HRQoL assessed at baseline, 3, 6 and 12 months using the 5-level EQ-5D version (EQ-5D-5L). EQ-5D-5L scores were converted into an index value ranging from 1 (full health) to 0 (worst possible health) using the Danish value set. <h3>Results</h3> At baseline, the mean (SD) EQ-5D-5L index values were 0.65 (0.15) for CCT-SE and 0.71 (0.12) for TAU. At 3 months, the index values were 0.71 (0.13) for CCT-SE and 0.75 (0.11) for TAU. At 6 months, the index value was 0.74 (0.15) for CCT-SE and 0.75 (0.16) for TAU. At 12 months, the index value was 0.76 (0.13) for CCT-SE and 0.78 (0.15) for TAU. Change in index value from baseline to 12 months was 0.11 in CCT-SE and 0.07 in the TAU group. <h3>Conclusions</h3> The CCT-SE intervention was associated with a greater improvement in HRQoL over 12 months when compared to TAU with improvement in the range of previously reported minimum clinically important difference for EQ-5D. <h3>Author(s) Disclosures</h3> The authors report no conflicts of interest.