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BACKGROUND/RATIONALE:
As of April 2008 over 4,000 U.S. military personnel have died in Iraq and more than 25,000 have been wounded in combat in Operations Iraqi and Enduring Freedom (OIF/OEF). TBI related to combat and accidents in combat theatres can cause life-long impairments in physical, cognitive, behavioral and social function that are usually more disabling concerning activities of daily living than the residual physical and deficits. Telerehabilitation: The proposed Low ADL Monitoring and telehealth Program (TBI LAMP) at the James Haley VAMC at Tampa, Fl (Tampa VA) will continue and expand the existing rehabilitation program in place for veterans discharged from the Level 1 Polytrauma/Blast Related (PT/BRI) Center at the Tampa VA with a diagnosis of mild and moderate TBI incurred in combat theatres. It will promote independence at home for veterans experiencing difficulties with activities of daily living with the aid of services rendered with assistive technology and home environmental modifications together with providing needed medical care via telehealth.
OBJECTIVE(S):
The goal of this proposed continuation of care program is to refine the existing LAMP to meet the needs of patients with combat related TBI and evaluate the impact of the program on patient and caregiver outcomes. The primary objectives of this 36 month quasi-experimental studies are to 1) Refine successful elements of TBI LAMP to meet the needs of OEF/OIF veterans with mild to moderate TBI. 2) Determine the immediate and sustained effects of LAMP on patient outcomes including function and community participation 3) Examine the perceived benefits and limitations of the LAMP service from the veteran and caregiver perspectives and 4) Evaluate the impact of LAMP on resource utilization (e.g., clinic visits, hospital bed days of care).
METHODS:
Study design: This 36 month study will use a quasi-experimental design to evaluate TBI LAMP care provided to a random sample of 45 OIF/OEF veterans discharged from the Tampa James A. Haley VAMC with a diagnosis of mild or moderate TBI. We will utilize quantitative analysis for evaluating changes in functional status, community participation, VA healthcare utilization, and veteran/family perceptions of LAMP. Inclusion characteristics: Veterans or active duty military personnel diagnosed with combat related TBI treated and discharged from the Tampa VA and residing within a two hour drive from the Tampa VA who are willing to accept technology in their homes for monitoring purposes and sign a consent form or have it signed by a proxy. LAMP services will be offered only to those patients with low ADL who require additional care and stand to benefit from the program. As of this writing, over 200 veterans with polytrauma, many with TBI from OIF/OEF have been treated at the Level 1 Polytrauma Center at the Tampa VA. Due to disenrollment and other issues we expect to follow a cohort of at least 45 veterans for at least a one year time period needed to assess the effectiveness of the LAMP program.
FINDINGS/RESULTS:
None at this time.
IMPACT:
None at this time.
PUBLICATIONS:
None at this time.
DRA:
Acute and Traumatic Injury, Mental Illness, Military and Environmental Exposures
DRE:
Rehabilitation
Keywords:
none
MeSH Terms:
none
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