The effect of telephone counselling on reducing post-traumatic symptoms after mild traumatic brain injury: A randomised trial

Kathleen R. Bell, J. M. Hoffman, N. R. Temkin, J. M. Powell, R. T. Fraser, P. C. Esselman, J. K. Barber, S. Dikmen

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

Background: Mild traumatic brain injury (MTBI) is a significant public health problem affecting approximately 1 million people annually in the USA. A total of 10-15% of individuals are estimated to have persistent posttraumatic symptoms. This study aimed to determine whether focused, scheduled telephone counselling during the first 3 months after MTBI decreases symptoms and improves functioning at 6 months. Methods: This was a two-group, parallel, randomised clinical trial with the outcome assessed by blinded examiner at 6 months after injury. 366 of 389 eligible subjects aged 16 years or older with MTBI were enrolled in the emergency department, with an 85% follow-up completion rate. Five telephone calls were completed, individualised for patient concerns and scripted to address education, reassurance and reactivation. Two composites were analysed, one relating to post-traumatic symptoms that developed or worsened after injury and their impact on functioning, the other related to general health status. Results: The telephone counselling group had a significantly better outcome for symptoms (6.6 difference in adjusted mean symptom score, 95% confidence interval (CI) 1.2 to 12.0), but no difference in general health outcome (1.5 difference in adjusted mean functional score, 95% CI 2.2 to 5.2). A smaller proportion of the treatment group had each individual symptom (except anxiety) at assessment. Similarly, fewer of the treatment group had daily functioning negatively impacted by symptoms with the largest differences in work, leisure activities, memory and concentration and financial independence. Conclusions: Telephone counselling, focusing on symptom management, was successful in reducing chronic symptoms after MTBI. Trial registration number: ClinicalTrials.gov, #NCT00483444.

Original languageEnglish (US)
Pages (from-to)1275-1281
Number of pages7
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume79
Issue number11
DOIs
StatePublished - Nov 2008

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Brain Concussion
Telephone
Counseling
Confidence Intervals
Leisure Activities
Wounds and Injuries
Health Status
Hospital Emergency Service
Anxiety
Randomized Controlled Trials
Public Health
Education
Health
Therapeutics

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Surgery
  • Medicine(all)

Cite this

The effect of telephone counselling on reducing post-traumatic symptoms after mild traumatic brain injury : A randomised trial. / Bell, Kathleen R.; Hoffman, J. M.; Temkin, N. R.; Powell, J. M.; Fraser, R. T.; Esselman, P. C.; Barber, J. K.; Dikmen, S.

In: Journal of Neurology, Neurosurgery and Psychiatry, Vol. 79, No. 11, 11.2008, p. 1275-1281.

Research output: Contribution to journalArticle

Bell, Kathleen R. ; Hoffman, J. M. ; Temkin, N. R. ; Powell, J. M. ; Fraser, R. T. ; Esselman, P. C. ; Barber, J. K. ; Dikmen, S. / The effect of telephone counselling on reducing post-traumatic symptoms after mild traumatic brain injury : A randomised trial. In: Journal of Neurology, Neurosurgery and Psychiatry. 2008 ; Vol. 79, No. 11. pp. 1275-1281.
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