Research Reports - Mobile phone text messaging to assess symptoms after mild traumatic brain injury and provide self-care support

J Head Trauma Rehabil. 2013 Jul-Aug;28(4):302-12

Suffoletto B, Wagner AK, Arenth PM, Calabria J, Kingsley E, Kristan J, Callaway CW

PURPOSE: To examine whether patients with mild traumatic brain injury (mTBI)
receiving text messaging-based education and behavioral support had fewer and
less severe postconcussive symptoms than those not receiving text-message
support. Our secondary objective was to determine the feasibility of using text
messaging to assess daily symptoms and provide support to patients with mTBI.
DESIGN: Randomized controlled trial with 14-day follow-up.
PARTICIPANTS: Convenience sample of 43 adult emergency department patients with
mTBI.
INTERVENTION: Fourteen days of timed SMS (short-message service) symptom
assessments (9 AM: headaches; 1 PM: difficulty concentrating; 5 PM: irritability
or anxiety) with self-care support messages.
MAIN MEASURES: SMS symptom reports, Rivermead Postconcussion Symptoms
Questionnaire.
RESULTS: Compared with the control group, intervention participants trended to
lower odds of reporting headaches (odds ratio [OR] = 0.38; 95% confidence
interval [CI]: 0.07-1.99), concentration difficulty (OR = 0.32; 95% CI:
0.04-2.24), and irritability or anxiety (OR = 0.33; 95% CI: 0.05-2.35). There
were also trends of lower mean scores for headaches (0.99 vs 1.19; P = .5),
difficulty concentrating (0.88 vs 1.23; P = .2), and irritability/anxiety (1.00
vs 1.62; P = .06). There were high response rate to SMS symptom assessments and
high satisfaction with the intervention.
CONCLUSION: Those receiving the text messaging-based education and support had
fewer and less severe postconcussive symptoms than the controls but none of the
differences reached statistical significance. Further evaluation of more robust
mobile interventions and larger sample of participants are still needed.

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