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Case management for people with acquired brain injury: feasibility and effectiveness of a two-year pragmatic randomized controlled trial.

Authors :
Stiekema APM
Rauwenhoff JCC
Bierlaagh D
Donkervoort M
Jansen N
Jurrius KHM
Zadoks J
van Heugten CM
Source :
Brain injury [Brain Inj] 2024 Sep 08, pp. 1-12. Date of Electronic Publication: 2024 Sep 08.
Publication Year :
2024
Publisher :
Ahead of Print

Abstract

Background: Case management (CM) aims to facilitate access to and integration of health care and social services. We investigated the feasibility and effectiveness of CM.<br />Methods: Randomized controlled trial with 219 patients and 114 caregivers randomly allocated to CM (109/59) or care as usual (110/55). CM was based on early and continuous online monitoring of problems and needs. Outcomes were assessed every 6 months with the Hospital Anxiety and Depression Scale (HADS). Secondary outcome domains were participant restrictions, life satisfaction, self-efficacy, caregiver burden, and needs. Multilevel modeling was used. Feasibility aspects were protocol delivery, participants' and case managers' satisfaction, and factors affecting implementation.<br />Results: There were no significant differences between groups. Participation restrictions and unmet needs decreased in both groups within 6 months. Monitoring was successful in 38, and 10 participants asked the CM for support. CM consisted mostly of providing information.<br />Discussion: CM based on early and continuous online monitoring does not have benefit in identifying and addressing problems early after relatively mild injury. Unsuccessful monitoring may have hindered access to the case manager and prevented us from evaluating CM as a complex intervention. It remains a challenge to early identify those who could benefit from care coordination.

Details

Language :
English
ISSN :
1362-301X
Database :
MEDLINE
Journal :
Brain injury
Publication Type :
Academic Journal
Accession number :
39245982
Full Text :
https://doi.org/10.1080/02699052.2024.2399070