BACKGROUND: Returning to work (RTW) in the UK is problematic following TBI. Vocational rehabilitation (VR) is limited and efficacy or costs seldom reported. This study aimed to determine whether a TBI specialist VR intervention (TBI VR) was more effective at work return and retention 12 months after injury than usual care (UC). Secondary aims were to explore the feasibility of collecting economic data to inform a definitive trial. METHOD: Work outcomes of TBI-VR were compared to UC. Ninety-four participants (40 TBI-VR) with TBI resulting in hospitalization ≥48 hours, who were working at injury were followed up by postal questionnaire at 3, 6 and 12 months post-hospital discharge. Primary outcome was RTW. Secondary outcomes were functional ability, mood and quality-of-life. Health resource use was measured by self-report. RESULTS: At 12 months, 15% more TBI-VR participants (27% more with moderate/severe TBI) were working than UC (27/36, 75% vs. 27/45, 60%). Mean TBI-VR health costs per person (consultant, GP, therapy, medication) were only £75 greater at 1 year. Secondary outcomes showed no significant baseline differences between groups. DISCUSSION: More TBI-VR participants returned to work than UC. People with moderate/severe TBI benefitted most. This positive trend was achieved without greatly increased health costs, suggesting cost-effectiveness. This study justifies the need for and can inform a definitive Randomized Controlled Trial (RCT).
BACKGROUND: Returning to work (RTW) in the UK is problematic following TBI. Vocational rehabilitation (VR) is limited and efficacy or costs seldom reported. This study aimed to determine whether a TBI specialist VR intervention (TBI VR) was more effective at work return and retention 12 months after injury than usual care (UC). Secondary aims were to explore the feasibility of collecting economic data to inform a definitive trial. METHOD: Work outcomes of TBI-VR were compared to UC. Ninety-four participants (40 TBI-VR) with TBI resulting in hospitalization ≥48 hours, who were working at injury were followed up by postal questionnaire at 3, 6 and 12 months post-hospital discharge. Primary outcome was RTW. Secondary outcomes were functional ability, mood and quality-of-life. Health resource use was measured by self-report. RESULTS: At 12 months, 15% more TBI-VR participants (27% more with moderate/severe TBI) were working than UC (27/36, 75% vs. 27/45, 60%). Mean TBI-VR health costs per person (consultant, GP, therapy, medication) were only £75 greater at 1 year. Secondary outcomes showed no significant baseline differences between groups. DISCUSSION: More TBI-VR participants returned to work than UC. People with moderate/severe TBI benefitted most. This positive trend was achieved without greatly increased health costs, suggesting cost-effectiveness. This study justifies the need for and can inform a definitive Randomized Controlled Trial (RCT).
Authors: Biren B Kamdar; Minxuan Huang; Victor D Dinglas; Elizabeth Colantuoni; Till M von Wachter; Ramona O Hopkins; Dale M Needham Journal: Am J Respir Crit Care Med Date: 2017-10-15 Impact factor: 21.405
Authors: Biren B Kamdar; Kristin A Sepulveda; Alexandra Chong; Robert K Lord; Victor D Dinglas; Pedro A Mendez-Tellez; Carl Shanholtz; Elizabeth Colantuoni; Till M von Wachter; Peter J Pronovost; Dale M Needham Journal: Thorax Date: 2017-09-16 Impact factor: 9.139
Authors: Han Su; Hilaire J Thompson; Kenneth Pike; Biren B Kamdar; Elizabeth Bridges; Megan M Hosey; Catherine L Hough; Dale M Needham; Ramona O Hopkins Journal: Aust Crit Care Date: 2022-02-21 Impact factor: 3.265
Authors: Annemieke C Scholten; Juanita A Haagsma; Martien J M Panneman; Ed F van Beeck; Suzanne Polinder Journal: PLoS One Date: 2014-10-24 Impact factor: 3.240
Authors: Frank G Hillary; Sarah M Rajtmajer; Cristina A Roman; John D Medaglia; Julia E Slocomb-Dluzen; Vincent D Calhoun; David C Good; Glenn R Wylie Journal: PLoS One Date: 2014-08-14 Impact factor: 3.240