Case Management for People with Acquired Brain Injury with Complex Problems (Part 1): Outcomes of a One-group Trial.

INTRODUCTION

Many people with acquired brain injury (PwABI) and their family face long-term psychosocial problems and unmet needs. Currently, there are no structural and integrated health care services supporting life after brain injury. We evaluated Case Management (CM) for PWABI which aims to facilitate access to and integration of health care and social services for people with complex problems.

METHODS

One-group repeated measures study including 62 PwABI and 36 caregivers in the Netherlands. Assessments were conducted every six months for 18-24 months. Primary outcome was psychosocial well-being (Hospital Anxiety and Depression Scale). Secondary outcomes were self-efficacy, participation, life satisfaction, and needs for PwABI and caregivers; and caregiver burden.

RESULTS

Anxiety reduced significantly in both PwABI and their caregivers. Over time, PwABI reported significantly fewer unmet needs, but more participation restrictions. Caregivers reported significantly less caregiver burden and more self-efficacy over time.

DISCUSSION

CM seems promising for reducing unmet needs in PwABI and improving some psychosocial outcomes in PwABI and caregivers. Lifelong CM may however be necessary. A randomized controlled study is needed to confirm whether the positive outcomes are due to CM.

CONCLUSION

This study warrants further research to establish the effectiveness of CM for PWABI.