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

Autor:	Stiekema APM; Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.; Limburg Brain Injury Center, Maastricht University, Maastricht, The Netherlands., Rauwenhoff JCC; Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.; Limburg Brain Injury Center, Maastricht University, Maastricht, The Netherlands., Bierlaagh D; Desiree Bierlaagh (self-employed), Houten, The Netherlands., Donkervoort M; Health Care and Social Work Division, Windesheim University of Applied Sciences, Almere, The Netherlands.; Mevrouw Slimmer Werken Social Innovation in Health Care and Well-Being, Drogteropslagen, Netherlands., Jansen N; Brain Injury Team, Brain Injury Network, Overijssel, Netherlands., Jurrius KHM; In-Tussen Foundation, Utrecht, the Netherlands., Zadoks J; In-Tussen Foundation, Utrecht, the Netherlands.; BreinDok Innovation in Care, Utrecht, the Netherlands., van Heugten CM; Limburg Brain Injury Center, Maastricht University, Maastricht, The Netherlands.; Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.
Jazyk:	angličtina
Zdroj:	Brain injury [Brain Inj] 2025 Jan 02; Vol. 39 (1), pp. 39-50. Date of Electronic Publication: 2024 Sep 08.
DOI:	10.1080/02699052.2024.2399070
Abstrakt:	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. 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. 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. 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.
Databáze:	MEDLINE
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