Mild Traumatic Brain Injury and Integrated Healthcare: A Pilot Study

Abstract

Research Objectives This pilot study aims to investigate post-concussive symptoms for individuals who received care from a specialized integrated concussion clinic compared to those who received standard care. Due to existing literature on use of integrated healthcare for treatment of various mental health diagnoses, as well as recommendations from professional organizations specializing in TBI, it was hypothesized that individuals who attended the clinic would have a reduction in post-concussive symptoms as compared to those who did not attend. Design Participants were referred to attend the concussion clinic for follow-up care after their hospital or outpatient visit. Participants were provided with the Multidisciplinary Examination of Neurotrauma Disorders (M.E.N.D.) at their visit or shortly after their missed appointment. Follow up on the M.E.N.D. was given approximately 6 months post injury. Setting The Concussion Clinic at Zuckerberg San Francisco General Hospital is a once-a-month outpatient clinic. Participants Participants (N= 38) included in this study were adults who were referred to attend the concussion clinic for follow-up care after their hospital or outpatient visit. Interventions Participants received the M.E.N.D. self-report questionnaire at time of visit at the concussion clinic, or shortly after their missed appointment, and approximately 6 months after the date of injury. Main Outcome Measures The M.E.N.D. is composed of the Neurobehavioral Symptom Inventory (NSI), and a TBI symptom questionnaire that is composed of the Patient Health Questionnaire-2 (PHQ-2), a two-item PTSD screener, and the 3-item Alcohol Use Disorders Identification Test Consumption (AUDIT-C). Results Consistent with our hypothesis, individuals who attended the clinic reported lower levels of post-concussive symptoms than those who did not attend the clinic. Specifically, the scores for the group that attended the concussion clinic decreased from an average score of 28.90 to 12.60 whereas scores from the "no show" group only slightly decreased from 31.13 to 30.25. Conclusions Findings suggest that use of a specialized integrated concussion clinic for treatment of mTBI may be helpful for those experiencing post-concussive symptoms; however, more research in this area is needed to substantiate these findings. Author(s) Disclosures None. This pilot study aims to investigate post-concussive symptoms for individuals who received care from a specialized integrated concussion clinic compared to those who received standard care. Due to existing literature on use of integrated healthcare for treatment of various mental health diagnoses, as well as recommendations from professional organizations specializing in TBI, it was hypothesized that individuals who attended the clinic would have a reduction in post-concussive symptoms as compared to those who did not attend. Participants were referred to attend the concussion clinic for follow-up care after their hospital or outpatient visit. Participants were provided with the Multidisciplinary Examination of Neurotrauma Disorders (M.E.N.D.) at their visit or shortly after their missed appointment. Follow up on the M.E.N.D. was given approximately 6 months post injury. The Concussion Clinic at Zuckerberg San Francisco General Hospital is a once-a-month outpatient clinic. Participants (N= 38) included in this study were adults who were referred to attend the concussion clinic for follow-up care after their hospital or outpatient visit. Participants received the M.E.N.D. self-report questionnaire at time of visit at the concussion clinic, or shortly after their missed appointment, and approximately 6 months after the date of injury. The M.E.N.D. is composed of the Neurobehavioral Symptom Inventory (NSI), and a TBI symptom questionnaire that is composed of the Patient Health Questionnaire-2 (PHQ-2), a two-item PTSD screener, and the 3-item Alcohol Use Disorders Identification Test Consumption (AUDIT-C). Consistent with our hypothesis, individuals who attended the clinic reported lower levels of post-concussive symptoms than those who did not attend the clinic. Specifically, the scores for the group that attended the concussion clinic decreased from an average score of 28.90 to 12.60 whereas scores from the "no show" group only slightly decreased from 31.13 to 30.25. Findings suggest that use of a specialized integrated concussion clinic for treatment of mTBI may be helpful for those experiencing post-concussive symptoms; however, more research in this area is needed to substantiate these findings.