Long-Term Health-Related Quality of Life and Perceptions of Recovery in Adults Who Received Clinical Profiles Informed Care for Concussion

OBJECTIVE: Document long-term health-related quality of life (HRQoL) and recovery perceptions in adults who received clinical profiles-informed concussion care and explore risk factors that predict poor long-term HRQoL outcomes. SETTING: Outpatient specialty concussion clinic. PARTICIPANTS: 125 adults, aged 18-65 years. DESIGN: A retrospective cohort design documented perceived recovery, negative life events, and Patient-Reported Outcomes Measurement Information System (PROMIS) scores in adults ( M = 33.44 years, SD = 13.31) who were medically cleared from concussion approximately 4.32 years (SD = 1.54, range = 1.11-6.30 years) following injury. Chi-square tests assessed associations among perceived recovery, negative life events, PROMIS scores, and select injury-related variables. MAIN MEASURES: Perceived Recovery Status, PROMIS Scale v1.2-Global Health, PROMIS 29 + 2 Profile, PROMIS v2.0-Cognitive Function, and Life Events List. RESULTS: Eighty-three percent (104/125) of participants reported still being recovered from concussion, and 85% (106/125) had <2 PROMIS scores exceeding 1SD (ie, within normal limits). Fifteen percent (19/125) exhibited >3 PROMIS scores beyond 1SD. Participants endorsing multiple negative self-events in the previous 12 months had 2.95 times greater odds ( χ2 [1, 125] = 4.64, P = .03, 95% CI = 1.07-8.11) of having ≥3 PROMIS scores beyond 1SD and 2.82 times greater odds ( χ2 [1, 125] = 4.66, P = .03, 95% CI = 1.07-7.42) of not being recovered compared to participants endorsing ≤1 negative self-events. In addition to negative self-events, only anxiety ( χ2 [1, 125] = 4.25, P = .04, OR: 3.64, 95% CI: 1.00-13.26) and depression ( χ2 [1, 125] = 5.92, P = .02, OR: 3.65, 95% CI: 1.23-10.87) history predicted ≥3 PROMIS scores beyond 1SD. Other injury-related factors, including any clinical profile, symptom burden, or prolonged recovery, did not ( P> .05). CONCLUSION: The majority of adults treated with a clinical-profiles-informed care model for concussion had normal HRQoL scores 1-6 years following recovery.