Effect of Video Discharge Instructions for Patients With Mild Traumatic Brain Injury in the Emergency Department: A Randomized Controlled Trial

Hoek, Amber E.; Joosten, Marieke; Dippel, Diederik W.J.; Beeck, Ed F. van; Hengel, Leandra van den; Dijkstra, Björn; Papathanasiou, Dafni; Rijssel, Daphne van; Hamer, Maaike van den; Schuit, Stephanie C. E.; Burdorf, Alex; Haagsma, Juanita A.; Rood, Pleunie P.M.

doi:10.1016/j.annemergmed.2020.10.023

Cited by 9 publications

(10 citation statements)

References 34 publications

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“…It is therefore important to provide patients or their next-of-kin information (orally and written) directly at the ED to search for medical help if they still experience post-traumatic complaints at 2 weeks postinjury. However, almost 50% of the patients could not reproduce oral or written information that was given at the ED and even adding video information to standard care at the ED did not improve the severity of post-traumatic symptoms 30 31. Another option to consider is to provide all non-hospitalised MHI patients with telephonic aftercare 2 weeks postinjury to assess feelings of post-traumatic complaints and depression since these factors were found to be predictors of incomplete recovery 17 32.…”

Section: Discussionmentioning

confidence: 99%

Incomplete recovery in patients with minor head injury directly discharged home from the emergency department: a prospective cohort follow-up study

et al. 2022

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ObjectivesTo determine the frequency of post-traumatic complaints and recovery rate of non-hospitalised patients with minor head injury (MHI) and their relationship with demographic and injury characteristics. We also evaluated the differences between patient groups in this least severe category of brain and head injury.DesignProspective cohort follow-up study.SettingPatients admitted to the emergency department (ED) of a tertiary hospital in the Netherlands.Participants242 patients with MHI (n=100 with head injury only and n=142 with mild traumatic brain injury (mTBI)) discharged home directly after evaluation at the ED.Outcome measuresThe primary outcome measure was incomplete recovery at 3 months measured by the Glasgow Outcome Scale-Extended score <8. Secondary outcome measures were number of post-traumatic complaints assessed 2 weeks and 3 months postinjury by a standardised questionnaire. Also the number of patients that visited their general practitioner because of persistent complaints was determined.ResultsThree months postinjury 48% of patients reported more than one post-traumatic complaint. Half (51%) of patients showed incomplete recovery. Incomplete recovery was associated with headache directly postinjury (OR 3.27, 95% CI 1.28 to 8.34), age (OR 1.02, 95% CI 1.00 to 1.05) and the number of post-traumatic complaints (OR 1.24, 95% CI 1.09 to 1.40) and depression (OR 6.31, 95% CI 1.24 to 32.00) 2 weeks postinjury. Incomplete recovery was comparable between the head injury only and mTBI group (55% vs 50%, 95% CI −12.5 to −23.0). In total 36 MHI patients (28%) visited their general practitioner because of complaints related to their head injury.ConclusionHalf of the non-hospitalised patients with MHI experienced incomplete recovery after 3 months without differences between head injury only and mTBI patients. Therefore, early identification of patients at risk for incomplete recovery must be started at the ED to provide appropriate aftercare to avoid long-term post-traumatic complaints.

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Section: Discussionmentioning

confidence: 99%

Incomplete recovery in patients with minor head injury directly discharged home from the emergency department: a prospective cohort follow-up study

et al. 2022

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“…This may influence the representativeness of the study. However, the characteristics of the eligible patients versus the patients who were included in the study were compared and showed no difference with respect to gender and ISS 30. Therefore, we assume that selection bias is small.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, respondents were asked to report healthcare use and productivity loss due to mTBI. Content of the interview was extensively explained by Hoek et al30…”

Section: Methodsmentioning

confidence: 99%

“…Data on healthcare consumption and productivity loss were acquired from the Mild traumatic brain injury and Outcomes from Visual patient Education trial (MOVIEtrial). 30 The MOVIE-trial is a multicenter pre-and postimplementation study of adult mTBI patients who presented at the ED of one of 6 participating hospitals in the Netherlands. The patients in the preimplementation group were included between December 2015 and October 2018.…”

Section: Study Design and Data Sourcementioning

confidence: 99%

“…However, the characteristics of the eligible patients versus the patients who were included in the study were compared and showed no difference with respect to gender and ISS. 30 Therefore, we assume that selection bias is small. Second, it should be taken into account that the time horizon for cost calculations was 3 months.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

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The Effect of Written and Video Discharge Instructions After Mild Traumatic Brain Injury on Healthcare Costs and Productivity Costs

Hoek

Geraerds

Rood

et al. 2021

Journal of Head Trauma Rehabilitation

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Objective: To compare healthcare and productivity costs between patients with mild traumatic brain injury (mTBI) who received verbal discharge instructions only and patients who received an additional flyer with or without video instructions. Setting: Emergency departments (EDs) of 6 hospitals in the Netherlands. Participants: In total, 1155 adult patients with mTBI (384 with verbal instructions; 771 with additional flyer with or without video instructions) were included. Design: Cost study with comparison between usual care and intervention. Methods: Medical and productivity costs up to 3 months after presentation at the ED were compared between mTBI patients with usual care and mTBI patients who received the intervention. Results: Mean medical costs per mTBI patient were slightly higher for the verbal instructions–only cohort (€337 vs €315), whereas mean productivity costs were significantly higher for the flyer/video cohort (€1625 vs €899). Higher productivity costs were associated with higher working age, injury severity, and postconcussion symptoms. Conclusion: This study showed that the implementation of flyer (and video) discharge instructions for patients with mTBI who present at the ED increased reports of postconcussion symptoms and reduced medical costs, whereas productivity costs were found to be higher for the working population in the first 3 months after the sustained head injury.

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Patient-centered mild traumatic brain injury interventions in the emergency department

Ray,

Luke,

Kreitzer

2024

The American Journal of Emergency Medicine

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Effect of Video Discharge Instructions for Patients With Mild Traumatic Brain Injury in the Emergency Department: A Randomized Controlled Trial

Cited by 9 publications

References 34 publications

Incomplete recovery in patients with minor head injury directly discharged home from the emergency department: a prospective cohort follow-up study

Incomplete recovery in patients with minor head injury directly discharged home from the emergency department: a prospective cohort follow-up study

The Effect of Written and Video Discharge Instructions After Mild Traumatic Brain Injury on Healthcare Costs and Productivity Costs

Patient-centered mild traumatic brain injury interventions in the emergency department

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