Effectiveness of a community‐based 3‐year advisory program after acquired brain injury

Abstract

Objective of this study was to examine the effectiveness of a coordinated, community based 3-year advisory program in 1534 patients with acquired brain injury. Patients and caregivers were offered a coordinated advisory program after discharge from rehabilitation. Patients in the historical control group received standard aftercare. The main outcomes were functional status [Functional Independence Measure (FIM)], and days spent in the acute hospital. The secondary outcome was survival. Patients were comparable for sex (intervention: 41.3% female, control: 38.0%), and younger in the control group (mean age intervention: 55.3, control: 49.6). Functional status at discharge was lower in the intervention group (mean FIM intervention: 66.2, control: 80.3). Patients in the intervention group experienced a moderate gain in FIM. Rate of days in hospital was 15.4 per 1000 person days (intervention) and 15.5 per 1000 person days (control). Patients of the intervention group had an increased rate of days in hospital. A total of 16.0% of patients in the intervention group and 19.3% in the control group died during follow-up. Patients in the intervention had a significant lower mortality risk depending on follow-up period and discharge FIM. The advisory program may be effective for all patients with acquired brain injury.

Community-Based Interventions After Acquired Brain Injury—A Systematic Review of Intervention Types and Their Effectiveness

“…Of all eligible studies, 5778 participants were included. Nearly half of the studies had relatively small sample sizes, with 50 or fewer subjects (see Supplemental Digital Content 3, available at: http://links.lww.com/JHTR/A521, for study characteristics); however, one included 1534 participants 32. The percentage of men ranged from 29% to 91%, and mean time since injury ranged from 6 months to 12 years postinjury.…”

“…The number of intervention sessions across all studies ranged from 435,36 to 96 sessions,37 with a median of 12 sessions across the 45 studies that included information on dosage. Intervention durations ranged from 2 weeks38 to 2 years 32. Many of the interventions (54%) were delivered during a 2- to 4-month time frame, with a median duration of 3 months across the 46 studies providing information on duration.…”

“…Nearly half of the studies had relatively small sample sizes, with 50 or fewer subjects (see Supplemental Digital Content 3, available at: http://links.lww.com/JHTR/ A521, for study characteristics); however, one included E358 Journal of Head Trauma Rehabilitation/September-October 2022 1534 participants. 32 The percentage of men ranged from 29% to 91%, and mean time since injury ranged from 6 months to 12 years postinjury. Mean age of the intervention groups ranged from 33 to 72 years.…”

“…Intervention durations ranged from 2 weeks 38 to 2 years. 32 Many of the interventions (54%) were delivered during a 2-to 4-month time frame, with a median duration of 3 months across the 46 studies providing information on duration.…”

“…30,34,[39][40][41] See Supplemental Digital Content 4 (available at: http://links.lww.com/ JHTR/A522) for details. Six studies aimed to improve global functioning, using ingredients such as counseling, and restorative and compensatory training of skills and body functions, 28,29,32,[42][43][44] 2 studies targeted psychosocial functioning through methods such as goal attainment, activity training, psychoeducation, and psychotherapy, 45,46…”