McCauley Katherine L, Wallace Tracey, Moran Timothy P, Palacios Javier, Forehand Dina, Breitenstein Jacquelyn, Miller Shannon C, Gore Russell K
SHARE Military Initiative, Shepherd Center, Atlanta, GA.
Department of Emergency Medicine, Emory University, Atlanta, GA.
Arch Rehabil Res Clin Transl. 2025 May 30;7(3):100468. doi: 10.1016/j.arrct.2025.100468. eCollection 2025 Sep.
To explore initial outcomes (treatment entry and completion and staff feedback) for an interdisciplinary military traumatic brain injury (TBI) treatment program with individualized support for co-occurring substance use (SU).
A quality improvement effort was undertaken to develop an integrated model of care for TBI with support for service members and veterans (SM/Vs) with co-occurring SU. We describe treatment entry and completion outcomes, along with staff feedback, collected over 26 months of program implementation.
An intensive outpatient program (IOP) for SM/Vs with TBI, administered by a not-for-profit hospital.
Three hundred and sixty-four (N=364) SM/Vs applying for TBI treatment (85.2% men, 28.3% active service, median age of 41 (interquartile range, ±12)).
An Integrated Care Model for TBI + SU was developed and flexibly applied to support client needs, including modifications to assessment, intervention, and follow-up support related to SU.
We report on instances of noncompletion because of SU, percentage of admission denials because of SU, demographic and clinical predictors of entering care, and qualitative feedback from treating clinicians.
Over 26 months, 188 individuals entered care, and just 7 who entered the IOP did not complete, with 1 of these instances because of SU. Clinician attitudes indicate optimism about the Integrated Care Model. Predictors of entering care, analyzed using logistic regression with recursive feature elimination, included multiple demographic (sex, race, location, service status) and clinical (SU and psychiatric history, brain injury symptom severity) characteristics.
An interdisciplinary TBI treatment environment holds promise as a setting for incorporating SU-related support to enhance entry and completion for more SM/Vs.
探讨一个跨学科军事创伤性脑损伤（TBI）治疗项目的初步成果（治疗进入与完成情况以及工作人员反馈），该项目为同时存在物质使用障碍（SU）的患者提供个性化支持。
开展了一项质量改进工作，以开发一种针对TBI的综合护理模式，为同时存在SU的现役军人和退伍军人（SM/Vs）提供支持。我们描述了在项目实施的26个月期间收集的治疗进入与完成情况结果以及工作人员反馈。
由一家非营利性医院管理的针对患有TBI的SM/Vs的强化门诊项目（IOP）。
364名申请TBI治疗的SM/Vs（85.2%为男性，28.3%为现役军人，中位年龄41岁（四分位间距为±12））。
开发并灵活应用了一种针对TBI + SU的综合护理模式，以支持患者需求，包括对与SU相关的评估、干预和后续支持进行调整。
我们报告了因SU导致的未完成治疗情况、因SU导致的入院拒绝百分比、进入治疗的人口统计学和临床预测因素，以及治疗临床医生的定性反馈。
在26个月期间，188人开始接受治疗，进入IOP的患者中只有7人未完成治疗，其中1例是因为SU。临床医生的态度表明对综合护理模式持乐观态度。使用带有递归特征消除的逻辑回归分析进入治疗的预测因素，包括多个人口统计学（性别、种族、地点、服役状态）和临床（SU和精神病史、脑损伤症状严重程度）特征。
一个跨学科的TBI治疗环境有望成为一个能够纳入与SU相关支持的场所，以提高更多SM/Vs的治疗进入率和完成率。
