Feasibility of an Interactive Coaching App to Enhance Post-concussion Outpatient Care

Abstract

Objectives: To determine the feasibility of patients to use a web-based health app for management of post-concussion (mTBI) symptoms in an out-patient setting.Participants: Seven (7) patients who were referred to an outpatient specialist clinic (physiatry) with persisting symptoms following a concussion. Participants had to be 18 years of age or older and more than 3 months post injury.Design: This was a prospective cohort study using a web-based platform for chronic disease management to guide patients in managing symptoms based on individual clinical recommendations. Each patient received weekly Symptom Management Plans created by a health coach and a physician specialist, designed to reinforce positive progress with clinical recommendations.Main Measures: Adherence to tracking daily recommendations and symptoms (data collected through the web-interface), The Rivermead Post-Concussion Questionnaire (self report) and a Satisfaction Questionnaire (self report).Results: Adherence to assigned clinical recommendations was close to 100%. Pre-post results on the patient reported outcome measure (Rivermead Post Concussion Tool) showed improvement for most patients in their experience of symptoms. The Satisfaction Questionnaire showed high rates of satisfaction with the App and the intervention in general.Conclusions: Use of a web-based health app with a health coach is feasible in this patient population from both the patient and clinician perspective based on high adherence. There is also some evidence of improvement of symptoms with this intervention over time. Further exploration of the use of this type of intervention with post-concussion patients could potentially impact long-term outcomes.

Conservative Management of Acute Sports-Related Concussions: A Narrative Review

“…Clinical trials of health coaching to aid with stress management and goal-setting in chronic pain patients show reduced psychological stress and improved resilience [184]. In the concussion literature, web-based resources combined with weekly coaching sessions produced improved outcomes and high patient satisfaction rates [185]. In a randomized trial, collaborative care, where coping skills, relaxation strategies, sleep hygiene, and positive thinking techniques were coached, showed significantly improved results in PPCS patients [186].…”

Enhancing COVID Rehabilitation with Technology (ECORT): protocol for an open-label, single-site randomized controlled trial evaluating the effectiveness of electronic case management for individuals with persistent COVID-19 symptoms

“…These platforms have been used across multiple disorders including diabetes [20][21][22], mental health [23][24][25], and cancer recovery [26,27]. These e-health platforms also offer the opportunity for improved communication between the patient, caregivers, and care providers, increasing both understanding of and adherence to treatment protocols [18,25,28,29]. In the case of Long COVID, the addition of a case management platform may prove particularly beneficial.…”

Enhancing COVID Rehabilitation with Technology (ECORT): Protocol for an open-label, single site randomized controlled trial evaluating the effectiveness of electronic case management for individuals with persistent COVID-19 symptoms.

“…(26,27) These e-health platforms also offer the opportunity for improved communication between the patient, caregivers and care providers, increasing both understanding of and adherence to treatment protocols. (18,25,28,29) In the case of Long COVID, the addition of a case management platform may prove particularly bene cial. As information is changing rapidly, patients may have more questions about their health concerns and their treatment plan.…”