Effect of a combined cognitive and vocational intervention on change in HRQoL after TBI

Research Objectives: To compare the effect of a combined cognitive and vocational intervention to treatment as usual (TAU) on change in health-related quality of life (HRQoL) after mild-to-moderate traumatic brain injury (TBI).

Design: Randomized controlled trial.

Setting: Specialized TBI outpatient clinic at Oslo University Hospital, Norway.

Participants: 116 patients aged 18-60 years with mild-to-moderate TBI were recruited 8-12 weeks post injury and randomized to the study intervention (n=60) or TAU (n=56). The participants’ mean age was 42 years (SD 9.8) and 60% (n = 69) were female. Injury severity was mild in 94% of cases and the most frequent cause of injury were falls (43%).

Interventions: Compensatory Cognitive Training (CCT) and Supported Employment (SE) or multidisciplinary TAU provided for a maximum of six months.

Main Outcome Measures: HRQoL assessed at baseline, 3, 6 and 12 months using the 5-level EQ-5D version (EQ-5D-5L). EQ-5D-5L scores were converted into an index value ranging from 1 (full health) to 0 (worst possible health) using the Danish value set.

Results: At baseline, the mean (SD) EQ-5D-5L index values were 0.65 (0.15) for CCT-SE and 0.71 (0.12) for TAU. At 3 months, the index values were 0.71 (0.13) for CCT-SE and 0.75 (0.11) for TAU. At 6 months, the index value was 0.74 (0.15) for CCT-SE and 0.75 (0.16) for TAU. At 12 months, the index value was 0.76 (0.13) for CCT-SE and 0.78 (0.15) for TAU. Change in index value from baseline to 12 months was 0.11 in CCT-SE and 0.07 in the TAU group.

Conclusions: The CCT-SE intervention was associated with a greater improvement in HRQoL over 12 months when compared to TAU with improvement in the range of previously reported minimum clinically important difference for EQ-5D.

Author(s) Disclosures: The authors report no conflicts of interest.