TBI Care
Trial question
What is the role of collaborative care in patients with traumatic brain injury and chronic pain?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
58.0% female
42.0% male
N = 158
158 patients (92 female, 66 male).
Inclusion criteria: adults with mild-to-severe traumatic brain injury and chronic pain.
Key exclusion criteria: substantial cognitive impairment; terminal illness or pain associated with cancer diagnosis; major surgery anticipated during the study period; bipolar disorder with psychotic features or current psychotic disorder.
Interventions
N=79 TBI care (collaborative care including 12 in-person or telephone visits over 16 weeks for CBT).
N=79 usual care (rehabilitation care for chronic pain).
Primary outcome
Mean reduction in pain interference on Brief Pain Inventory at 4 months
3.46 points
5.03 points
5.0 points
3.8 points
2.5 points
1.3 points
0.0 points
TBI
care
Usual
care
Significant
decrease ▼
Significantly lower reduction in mean pain interference on BPI at 4 months (3.46 points vs. 5.03 points; AD -1.57 points, 95% CI -2.5 to -0.64).
Secondary outcomes
Significantly greater reduction in mean pain interference on BPI at 8 months (3.61 points vs. 4.68 points; AD 1.07 points, 95% CI 0.05 to 2.09).
Significantly lower reduction in pain severity on BPI at 4 months (3.63 points vs. 4.9 points; AD -1.27 points, 95% CI -2.02 to -0.52).
Significantly lower reduction in GAD-7 at 4 months (6.2 vs. 9.58; AD -3.38 , 95% CI -6.44 to -0.32).
Conclusion
In adults with mild-to-severe traumatic brain injury and chronic pain, TBI care was superior to usual care with respect to mean reduction in pain interference on BPI at 4 months.
Reference
Jeanne M Hoffman, Mary Curran, Jason Barber et al. Collaborative Care for Chronic Pain After Traumatic Brain Injury: A Randomized Clinical Trial. JAMA Netw Open. 2024 Jun 3;7(6):e2413459.
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