Outcomes and lessons learned from a randomized controlled trial to reduce health care utilizations during the first year after spinal cord injury rehabilitation: Telephone counseling versus usual care

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Abstract:

Study evaluated the effectiveness of telephone counseling (TC) in reducing medical complications and health care utilization and improving psychosocial outcomes during the first year after spinal cord injury (SCI) rehabilitation. A total of 168 patients participated in a single-site, single-blind, randomized controlled trial comparing usual care plus TC with usual care (UC). The TC group received up to eleven 30- to 45-minute scheduled telephone calls to provide education, resources, and support. The UC group received indicated referrals and treatment. The primary outcome was a composite of self-reported health care utilization and medical complications. Secondary outcomes were depression severity, current health state, subjective health, and community participation. No significant differences were observed between TC and UC groups in the primary or secondary psychosocial outcomes. This study had a number of strengths, but included potential design weaknesses. Intervention studies would benefit from prescreening participants to identify those with treatable problems, those at high risk for poor outcomes, or those with intentions to change target behaviors. Interventions focused on treatment goals and designed to work in collaboration with the participant’s medical care system may lead to improved outcomes.

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