Session IX - Injury Prevention

Sat., 10/7/06 Geriatrics & Injury Prevention, Paper #54, 9:27 am

A Multidisciplinary Group Intervention Program to Promote Recovery after Minor Traffic Injuries: A Randomized Controlled Trial

Carin Ottosson, MD1,2 (*); Hans Pettersson, PhD3 (*);
Sven-Erik Johansson, PhD4 (*); Olof Nyrén, MD, PhD1 (*); Sari Ponzer, MD, PhD1 (a-Cancer och Trafikskadades Fvrbund);
1Department of Orthopaedics, Karolinska Institutet at Stockholm Söder Hospital, Stockholm, Sweden;
2Department of Biostatistics, Karolinska Institutet at Stockholm Söder Hospital, Stockholm, Sweden;
3Center for Family Medicine, Karolinska Institutet, Stockholm, Sweden

Purpose: Our objective was to evaluate whether a multidisciplinary group intervention in the acute stage after traffic-related minor injuries could affect the by-patient reported recovery rate at 12 months

Methods: In this randomized controlled trial, consecutive patients (>18 years) with an acute (<24 hours) minor musculoskeletal injury after a motor vehicle collision and presenting a profile of risk of nonrecovery according to the Prediction of PsychoSocial-Risk (PPS-Risk) questionnaire were eligible. The PPS-Risk is a novel instrument for early identification of patients with risk for delayed recovery after trauma and was developed by our group. It aims to identify patients at risk of reporting nonrecovery and divides the patients as high- or low-risk individuals regarding the risk of nonrecovery. A total of 127 patients were included, of whom 65 were randomized into the intervention and 62 into the control group. All patients received medical treatment according to routine protocols at our department. The intervention program included four group sessions (weekly, open group) with a focus on normal physical and psychological reactions to trauma and how to manage pain. The control group was followed up according to the routines at the hospital. The primary outcome measure was by patient-reported recovery at 12 months. Secondary outcome measures were ratings of pain and mental distress (VAS), the SF-36, and self-reported sick leave.

Results: At 12-month follow-up, 52% (33/63) of the High-Risk Intervention patients reported recovery compared to 31% (18/59) of the High-Risk Control patients (P = 0.03). No significant differences could be detected between the groups regarding the secondary outcome measures.

Conclusion/Significance: A simple group intervention for patients with minor injuries influenced the 12-month outcome in terms of self-reported recovery but no differences could be detected regarding the duration of sick leave or the secondary outcome measures. Minor injuries, including whiplash-related neck injuries caused by motor vehicle collisions, are common and may result in a lengthy recovery process for some individuals. An intervention in an early stage after injuries that increases the recovery rate can not only reduce patient suffering but can even reduce the costs for the society.

If noted, the author indicates something of value received. The codes are identified as a-research or institutional support; b-miscellaneous funding; c-royalties; d-stock options; e-consultant or employee; n-no conflicts disclosed, and *disclosure not available at time of printing.
· The FDA has not cleared this drug and/or medical device for the use described in this presentation (i.e., the drug or medical device is being discussed for an "off label" use). · · FDA information not available at time of printing.