Psychological impact of injuries sustained in motor vehicle crashes: systematic review and meta-analysis

Craig, Ashley; Tran, Yvonne; Guest, Rebecca; Gopinath, Bamini; Jagnoor, Jagnoor; Bryant, Richard A.; Collie, Alex; Tate, Robyn; Kenardy, Justin; Middleton, James; Cameron, Ian D.

doi:10.1136/bmjopen-2016-011993

Cited by 107 publications

(106 citation statements)

References 74 publications

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“…It has been shown that an ongoing compensation process affects the claimants' quality of life negatively, both physically and mentally [13,22] and that a prolonged time to claim closure is a negative prognostic parameter [13,23]. Indirectly, this could be correlated with being an experience of non-recovery after the index trauma [24] and support the "compensation theory" [14]. In this study, no difference in outcome between the participants with open and closed cases could be detected.…”

Section: Discussionmentioning

confidence: 47%

Long-term follow-up of whiplash injuries reported to insurance companies: a cohort study on patient-reported outcomes and impact of financial compensation

et al. 2018

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Purpose The long-term outcome of Whiplash-associated disorder (WADs) has been reported to be poor in populations from medical settings. However, no trials have investigated the long-term prognosis of patients from medico-legal environment. For this group, the "compensation hypothesis" suggests financial compensation being associated with worsened outcome. The aims of this study were to describe long-term (2-4 years) non-recovery rates in participants with WAD recruited from insurance companies and to investigate the association between self-reported non-recovery and financial compensation. Methods 144 participants, reporting neck pain after a motor vehicle accident, were recruited from two major insurance companies in Sweden. Self-reported recovery was measured at 6 months and 2-4 years. Those who received financial compensation from an insurance company were compared with those who received no compensation. Results The overall non-recovery rate after 2-4 years was 55.9% (66/118). In the non-compensated group, the non-recovery rate was 51.0% (25/49) and in the compensated group 73% (27/37) (p = 0.039). Adjusted OR was 4.33 (1.37-13.66). High level of pain at baseline was a strong predictor of non-recovery ]. However, no association was found between pain level at baseline and financial compensation. Conclusions The non-recovery rate among patients making insurance claims is high, especially among those receiving financial compensation even if causal relationship cannot be determined based on this study. However, lack of association between baseline level of pain and compensation supports the compensation hypothesis.

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Section: Discussionmentioning

confidence: 47%

Long-term follow-up of whiplash injuries reported to insurance companies: a cohort study on patient-reported outcomes and impact of financial compensation

et al. 2018

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“…Psychosocial factors are important determinants of outcome after work injury [20, 21]. The biopsychosocial approach has been widely advocated in medicine, but, based on communication with insurance companies, the biopsychosocial model does not seem to have been fully adopted into the compensation systems as yet.…”

Section: Discussionmentioning

confidence: 99%

Health care professionals’ attitudes towards evidence-based medicine in the workers’ compensation setting: a cohort study

Elbers

Chase²,

Craig

et al. 2017

BMC Med Inform Decis Mak

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BackgroundProblems may arise during the approval process of treatment after a compensable work injury, which include excess paperwork, delays in approving services, disputes, and allegations of over-servicing. This is perceived as undesirable for injured people, health care professionals and claims managers, and costly to the health care system, compensation system, workplaces and society. Introducing an Evidence Based Medicine (EBM) decision tool in the workers’ compensation system could provide a partial solution, by reducing uncertainty about effective treatment. The aim of this study was to investigate attitudes of health care professionals (HCP) to the potential implementation of an EBM tool in the workers’ compensation setting.MethodsThe study has a mixed methods design. The quantitative study consisted of an online questionnaire asking about self-reported knowledge, attitudes and behaviour to EBM in general. The qualitative study consisted of interviews about an EBM tool being applied in the workers’ compensation process. Participants were health care practitioners from different clinical specialties. They were recruited through the investigators’ clinical networks and the workers’ compensation government regulator’s website.ResultsParticipants completing the questionnaire (n = 231) indicated they were knowledgeable about the evidence-base in their field, but perceived some difficulties when applying EBM. General practitioners reported having the greatest obstacles to applying EBM. Participants who were interviewed (n = 15) perceived that an EBM tool in the workers’ compensation setting could potentially have some advantages, such as reducing inappropriate treatment, or over-servicing, and providing guidance for clinicians. However, participants expressed substantial concerns that the EBM tool would not adequately reflect the impact of psychosocial factors on recovery. They also highlighted a lack of timeliness in decision making and proper assessment, particularly in pain management.ConclusionsOverall, HCP are supportive of EBM, but have strong concerns about implementation of EBM based decision making in the workers’ compensation setting. The participants felt that an EBM tool should not be applied rigidly and should take into account clinical judgement and patient variability and preferences. In general, the treatment approval process in the workers’ compensation insurance system is a sensitive area, in which the interaction between HCP and claims managers can be improved.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-017-0460-2) contains supplementary material, which is available to authorized users.

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“…Most reported transport accidents result in minor injuries (75%), mostly musculoskeletal and/or soft tissue injuries . The injury itself, regardless of severity, may lead to permanent mental and physical impairments and disabilities . Even though minor injuries comprise approximately 75% of all road transport injuries, poor physical and mental health outcomes in this group have received little attention .…”

Section: Introductionmentioning

confidence: 99%

“…Even though minor injuries comprise approximately 75% of all road transport injuries, poor physical and mental health outcomes in this group have received little attention . Among participants with minor injuries, there are individuals at high risk of substantial poor recovery and on‐going disability . Hence, permanent or temporary disabilities arising from minor injuries pose an on‐going problem for the compensation and health‐care system .…”

Section: Introductionmentioning

confidence: 99%

Biopsychosocial barriers affecting recovery after a minor transport‐related injury: A qualitative study from Victoria

Samoborec

Ayton

Ruseckaite

et al. 2019

Health Expectations

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ObjectiveThe aim of the study was to understand the recovery phenomena and to explore participants' perspectives on the biopsychosocial facilitators and barriers affecting their recovery after a minor transport injury.MethodsA qualitative method was used involving semi‐structured interviews with 23 participants who sustained a minor transport injury. Interviews and analysis were guided by the biopsychosocial model (BPS) of health. The outcomes were themes capturing biopsychosocial barriers to, and personal experiences of, recovery using a previously defined framework.ResultsThe themes indicate that recovery is a multifaceted phenomenon affected by comorbidities such as chronic pain, depression and anxiety. A range of subsequent complexities such as the inability to self‐care and undertaking daily domestic duties, and incapacity to participate in recreational activities were major barriers to recovery. These barriers were found to be an on‐going source of frustration, dissatisfaction and a perceived cause of depressive symptomatology in many participants. Most participants reported mixed feelings of the care received. Other common issues raised included a lack of understanding of the assessment time, regular follow‐up, guidance and on‐going support.ConclusionThis study revealed that recovery after a minor transport‐related injury was a challenging, complex, demanding and a long‐term process for the individuals in this study. Findings from this limited cohort suggested that, for participants to return to their pre‐accident health status, a more coordinated approach to information and care delivery may be required.

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Psychological impact of injuries sustained in motor vehicle crashes: systematic review and meta-analysis

Cited by 107 publications

References 74 publications

Long-term follow-up of whiplash injuries reported to insurance companies: a cohort study on patient-reported outcomes and impact of financial compensation

Long-term follow-up of whiplash injuries reported to insurance companies: a cohort study on patient-reported outcomes and impact of financial compensation

Health care professionals’ attitudes towards evidence-based medicine in the workers’ compensation setting: a cohort study

Biopsychosocial barriers affecting recovery after a minor transport‐related injury: A qualitative study from Victoria

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