Effects of case management after brain injury: A systematic review

BACKGROUND: Adults who survive traumatic brain injury (TBI) often receive case (care) management to overcome the difficulties commonly faced negotiating a number of different health and social care services and systems. Little is known about the effectiveness of a case management intervention. OBJECTIVE: To examine the effects of case management for patients with severe head injury on outcome, family function, and provision of rehabilitation services. METHODS: Systematic review methodology. Electronic databases (Medline, CINAHL, Psycbite and OTSeeker) were searched up to 7/1/2013. A total of 655 articles were screened of which six met the criteria for inclusion in the review. Study quality was evaluated using the PEDro scale or AMSTAR checklist dependent on study design. RESULTS: One systematic review, three controlled trials and two case series reports were appraised. There was significant clinical heterogeneity between studies and studies scored poorly on the appraisal checklists. Due to methodological limitations, there was no clear evidence of effectiveness or ineffectiveness of case management after brain injury. CONCLUSION: Principal findings are that there is a paucity of applicable research on case management, and a need to evaluate the impact of case management on life participation outcomes.