A pilot randomized controlled trial of an early multidisciplinary model to prevent disability following traumatic injury

Abstract

Early findings point to the value of early screening to identify patients at risk of treatable pain, physical, and psychological impairments. Moreover, early multidisciplinary intervention models following traumatic injury show promise for protecting against the onset of posttraumatic psychological disorders.

Multidisciplinary outpatient treatment in patients with mild traumatic brain injury: A randomised controlled intervention study

“…Similar to other authors, we found a tendency for less frequent health care use among patients receiving multidisciplinary treatment [37,40]. This finding could be by chance, but the use of other health care services by patients receiving multidisciplinary treatment must be investigated in other studies.…”

The Association Between Daily Posttraumatic Stress Symptoms and Pain Over the First 14 Days After Injury: An Experience Sampling Study

“…To our knowledge, this study is also the first to utilize the DSM‐5 Criterion A (e.g., patient self‐report of whether the event involved actual or threatened death, serious injury, or sexual violence) to screen for a potentially traumatic event among injured patients. To date, one of the standard screening instruments to determine eligibility for early cognitive‐behavioral intervention studies has been satisfying Criterion A of the DSM‐IV PTSD diagnosis . This screening based on DSM‐IV included a subjective assessment of emotions associated with the event (e.g., fear, helplessness, or horror).…”

Traumatic brain injury and adjustment disorders

“…This model of a therapeutic approach appears protective against the development of PTSD symptoms. Namely, in contrast to the 24% of patients undergoing conventional health care after the injury presenting with PTSD symptoms, none of the patients assigned to a multidisciplinary model had the characteristic symptoms following exposure to trauma 6 months after the injury [10]. Another research indicates that the poor outcome associated with memory, executive functions, attention and information processing speed, are connected with self-reported depression and anxiety after TBI, and adaptive coping strategies have greater influence on the level of depression in individuals with a lower information processing speed [11].…”

“…One group of studies examined the impact of psychological symptoms early after injury in the further course of the recovery and broader life-social consequences. Thus, a pilot study which included 142 patients with mild to moderate traumatic head injury found that the intensity of acute pain, post-traumatic adjustment, depression and acute trauma symptoms, as well as the use of alcohol, were significant predictors of the severity of pain, depression, post traumatic stress symptoms, as well as physical mobility 6 months after the injury [10]. Early multidisciplinary treatment, which involves pain therapists, physical medicine specialists, psychotherapists, occupational therapists, and clinical psychologists in the first and third months after injury, leads to a significant relief of pain symptoms 6 months later.…”