OBJECTIVE: Persistent cognitive, emotional, and somatic symptoms after mild traumatic brain injury (mTBI) and co-occurring health conditions require multimodal treatment approaches. In this study, the authors assessed the efficacy of an integrated practice unit (IPU) approach to treat veterans with chronic post-mTBI symptoms and co-occurring conditions. METHODS: Patient-reported outcomes were retrospectively assessed with scores on the Neurobehavioral Symptom Inventory (NSI), PTSD Checklist for DSM-5 (PCL-5), Life Satisfaction Questionnaire-11 (LiSaT-11), Participation of Recombined Tools-objective (PART-O), and Patient Global Impression of Change (PGIC) instruments during and after participation in an intensive outpatient program. Unadjusted analyses were conducted with paired t tests between time points, and linear mixed models that were controlled for demographic factors were used to evaluate changes in NSI and PCL-5 scores between time points. RESULTS: Records from 219 participants (88% men), mean±SD age=45.8±9.6 years, were included. Total NSI, PCL-5, and LiSaT-11 scores improved from admission to discharge and to 1 month after discharge; observed effect sizes were medium to very large. Average PART-O total scores did not significantly improve between admission and 1 month postdischarge. The observed improvements in total NSI and PCL-5 scores remained statistically significant after analyses were adjusted for demographic factors. Responder analyses indicated clinically meaningful improvements in mTBI and posttraumatic stress symptoms. Nearly all participants endorsed positive PGIC statements at discharge and 1 month postdischarge. CONCLUSIONS: The IPU approach to the evaluation and management of persistent post-mTBI symptoms and co-occurring conditions suggests significant symptom reduction and improvement in wellness in a veteran population.
Elmer et al. (Thu,) studied this question.