Outcomes and Lessons Learned From a Randomized Controlled Trial to Reduce Health Care Utilization During the First Year After Spinal Cord Injury Rehabilitation: Telephone Counseling Versus Usual Care

Mackelprang, Jessica L.; Hoffman, Jeanne M.; Garbaccio, Chris; Bombardier, Charles H.

doi:10.1016/j.apmr.2016.03.002

Cited by 18 publications

(17 citation statements)

References 19 publications

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“…Data were gathered from 169 adults with traumatic SCI who completed a randomized controlled trial that compared telephone counseling interventions with usual care across the first year following discharge from IR [22]. Full inclusion criteria are those of the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) funded Spinal Cord Injury Model System [23].…”

Section: Methodsmentioning

confidence: 99%

Urinary tract infections and bladder management over the first year after discharge from inpatient rehabilitation

Stillman

Hoffman

Barber

et al. 2018

Spinal Cord Ser Cases

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Study Design Secondary analysis of data from a prospective clinical trial of telephone counseling. Objectives To describe changes in bladder management and development of bladder-related complications in the first year after discharge from inpatient spinal cord injury (SCI) rehabilitation. To determine whether urinary tract infection (UTI) is associated with bladder management technique or severity of SCI during this time period. Setting One SCI Model System center. Methods Post hoc analysis of bladder-specific responses to a phone intervention meant to reduce secondary complications of paralysis in adults (n = 169) over the first year after discharge from initial inpatient rehabilitation (IR). Results Bladder management was associated with injury level during and immediately after inpatient rehabilitation, and with American Spinal Injury Association (ASIA) Impairment Scale (AIS) score over the entire year. During one year of followup, 19% of patients changed bladder management techniques. Among participants performing intermittent catheterization (IC), 20% had urinary incontinence weekly or more frequently. The cumulative incidence of UTI was 71% by the end of the study, and between 27 and 46% of subjects reported UTIs during each 3-month period. Subjects with spontaneous voiding reported significantly fewer UTIs than those using IC or indwelling catheterization (IDC), but there was no significant difference in UTIs between IC and IDC. Conclusion During the first year following discharge, approximately one in five patients changed the bladder management technique and urinary incontinence occurred in a substantial proportion of those performing IC. These findings suggest a need for more frequent monitoring of bladder changes and complications over the first year after IR.

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Section: Methodsmentioning

confidence: 99%

Urinary tract infections and bladder management over the first year after discharge from inpatient rehabilitation

Stillman

Hoffman

Barber

et al. 2018

Spinal Cord Ser Cases

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“…A confounding factor may be that a number of the studies [8,17] didn't evaluate the necessity of participating in the study. Thus, they may have included individuals with little need for interventions to address health or psychosocial outcomes, and findings may not be as robust as they would have been if all participants had clinical needs.…”

Section: Discussionmentioning

confidence: 99%

“…A single-site, single-blinded RCT evaluating 168 individuals receiving usual care plus telephone counseling vs. usual care alone [17] evaluated self-reported health care utilization and medical complications, depression severity, current health state, subjective health and community participation in the US. The groups were similar at baseline, except that more control participants were married.…”

Section: Direct To Consumermentioning

confidence: 99%

Telehealth for people with spinal cord injury: a narrative review

et al. 2018

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Study design Narrative review. Objectives To find and discuss what has been published about the use of telehealth, on people with spinal cord injury (teleSCI). Setting International. Method Cochrane Library, Ovid Medline, EMBASE and CINAHL, from 1996 till June 2017 have been searched. Searches in PsycINFO, from 1996 till September 2017, were included afterwards. Extracted data include studies in English language, containing information about spinal cord injury and disorders, and telehealth. Literature reviews, systematic reviews, and studies containing other types of neurological disorders, were excluded. Studies were grouped based on how and to whom telehealth was offered.Results Twenty nine studies were included in the review. They were categorized according to the way teleSCI was provided, and to what modality was used. Some studies utilized more than one modality. TeleSCI seems to be favorable concerning treatment and follow-up, as well as favorable socioeconomically and environmentally. The studies spanned across several aims and outcomes. There was also heterogeneity in number of participants, the differences in modalities, and in the level of evidence. Thus it was challenging to compare studies and make future recommendations. Conclusions TeleSCI can be used for examination and guiding purposes. Further research is warranted to evaluate optimal utilization, methodology and efficacy. Sponsorship The first author has received funding from the Norwegian Extra Foundation.

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“…Our model of care (including telephone calls, home visits, $AU80 and an illustrated book) was adapted from evidence-based models used in high-income countries; and drew from evidence about the effectiveness of community-based rehabilitation in LMICs [ 14 ] and telephone-based support for people with SCI and other types of disabilities in high-income countries [ 15 , 16 ]. It was also based on a study where we demonstrated the feasibility of providing advice over the telephone for people with pressure injuries in a clinical trial involving 120 people from India and Bangladesh [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Understanding how a community-based intervention for people with spinal cord injury in Bangladesh was delivered as part of a randomised controlled trial: a process evaluation

et al. 2020

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Design Mixed methods study Setting Community, Bangladesh Objectives To understand how a community-based intervention for people with spinal cord injury (SCI) in Bangladesh was delivered as part of a randomised controlled trial and to gauge the perceptions of participants and healthcare professionals to the intervention. Methods A community-based intervention was administered to 204 participants as part of a large randomised controlled trial (called the CIVIC trial). Case-managers followed-up participants with regular telephone calls and home visits over the first 2 years after discharge. The following data were collected alongside the trial: (i) chart audit of telephone calls and home visits (ii) recordings of 20 telephone calls (iii) interviews with 14 Intervention participants and four healthcare professionals including three case-managers. Results Participants received the target number of telephone calls and home visits. Pressure injuries were identified as a problem during at least one telephone call by 43% of participants. Participants and case-managers valued regular telephone calls and home visits, and believed that calls and visits prevented complications and alleviated social isolation. Participants trusted case-managers and were confident in the care and advice provided. Case-managers expressed concerns that people with SCI in Bangladesh face many problems impacting on well-being and motivation stemming from poverty, limited employment opportunities, societal attitudes and inaccessible environments. Conclusion A community-based intervention involving regular telephone calls and home visits was administered as intended and was well received by the recipients of the care. Nonetheless, people with SCI in Bangladesh face economic and social problems which cannot be fully addressed by this type of intervention alone.

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Outcomes and Lessons Learned From a Randomized Controlled Trial to Reduce Health Care Utilization During the First Year After Spinal Cord Injury Rehabilitation: Telephone Counseling Versus Usual Care

Cited by 18 publications

References 19 publications

Urinary tract infections and bladder management over the first year after discharge from inpatient rehabilitation

Urinary tract infections and bladder management over the first year after discharge from inpatient rehabilitation

Telehealth for people with spinal cord injury: a narrative review

Understanding how a community-based intervention for people with spinal cord injury in Bangladesh was delivered as part of a randomised controlled trial: a process evaluation

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