Effects of a modular telehealth intervention on comorbid conditions in service members with mild traumatic brain injury

ObjectiveMany active duty service members with mild traumatic brain injury (mTBI) report comorbidities such as depression, anxiety, PTSD, insomnia, and pain. We analyzed data from a prior randomized controlled trial (RCT) to examine the effects of evidence-based treatment modules, delivered by telep...

Full description

Saved in:
Bibliographic Details
Main Authors: Jesse R. Fann, Tessa Hart, Kathleen R. Bell, Wesley Cole, Sonia Jain, Rema Raman, Jason Barber, Sureyya Dikmen, John Richardson, Murray B. Stein, Nancy Temkin
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1594748/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849411581461397504
author Jesse R. Fann
Jesse R. Fann
Tessa Hart
Kathleen R. Bell
Wesley Cole
Sonia Jain
Rema Raman
Jason Barber
Sureyya Dikmen
Sureyya Dikmen
John Richardson
Murray B. Stein
Murray B. Stein
Murray B. Stein
Nancy Temkin
Nancy Temkin
Nancy Temkin
author_facet Jesse R. Fann
Jesse R. Fann
Tessa Hart
Kathleen R. Bell
Wesley Cole
Sonia Jain
Rema Raman
Jason Barber
Sureyya Dikmen
Sureyya Dikmen
John Richardson
Murray B. Stein
Murray B. Stein
Murray B. Stein
Nancy Temkin
Nancy Temkin
Nancy Temkin
author_sort Jesse R. Fann
collection DOAJ
description ObjectiveMany active duty service members with mild traumatic brain injury (mTBI) report comorbidities such as depression, anxiety, PTSD, insomnia, and pain. We analyzed data from a prior randomized controlled trial (RCT) to examine the effects of evidence-based treatment modules, delivered by telephone, on the number and symptom burden of five common comorbidities.Setting and participants356 service members from two military medical centers who had sustained deployment-related mTBI in the preceding 2 years.DesignSecondary analysis of RCT comparing 6 months of telephone-delivered problem-solving treatment (PST) with comorbidity-specific modules to education only (EO).Main measuresComorbidity burden measured by Patient Health Questionnaire-9, Brief Symptom Inventory-Anxiety, PTSD Checklist, Pittsburgh Sleep Quality Inventory, Rivermead Postconcussion Symptoms Questionnaire (headache item) assessed at baseline and 6 and 12 months.Results47% of service members endorsed ≥ 3 comorbidities at baseline. At 6 months, the PST group had significantly fewer comorbidities, greater improvement in depression, anxiety, PTSD, and sleep, but not headache, and higher response/remission rates for depression and sleep, compared to EO. There were no significant group differences at 12 months.ConclusionTelephone-delivered PST with comorbidity-specific modules reduces burden of comorbidities after deployment-related mTBI. Research is needed on how to maintain improvements over time.
format Article
id doaj-art-51c4d993a05443b9aec24eaf7c7c83c3
institution Kabale University
issn 1664-2295
language English
publishDate 2025-07-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Neurology
spelling doaj-art-51c4d993a05443b9aec24eaf7c7c83c32025-08-20T03:34:44ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-07-011610.3389/fneur.2025.15947481594748Effects of a modular telehealth intervention on comorbid conditions in service members with mild traumatic brain injuryJesse R. Fann0Jesse R. Fann1Tessa Hart2Kathleen R. Bell3Wesley Cole4Sonia Jain5Rema Raman6Jason Barber7Sureyya Dikmen8Sureyya Dikmen9John Richardson10Murray B. Stein11Murray B. Stein12Murray B. Stein13Nancy Temkin14Nancy Temkin15Nancy Temkin16Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United StatesDepartment of Rehabilitation Medicine, University of Washington, Seattle, WA, United StatesMoss Rehabilitation Research Institute, Elkins Park, PA, United StatesDepartment of Physical Medicine and Rehabilitation, University of Texas Southwestern, Dallas, TX, United StatesDepartment of Brain Injury Medicine, Womack Army Medical Center, Fort Bragg, NC, United StatesHerbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United StatesAlzheimer’s Therapeutic Research Institute, University of Southern California, Los Angeles, CA, United StatesDepartment of Neurological Surgery, University of Washington, Seattle, WA, United StatesDepartment of Rehabilitation Medicine, University of Washington, Seattle, WA, United StatesDepartment of Neurological Surgery, University of Washington, Seattle, WA, United StatesDepartment of Health Management and Policy, University of Michigan, Ann Arbor, MI, United StatesHerbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States0Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States1VA San Diego Healthcare System, San Diego, CA, United StatesDepartment of Rehabilitation Medicine, University of Washington, Seattle, WA, United StatesDepartment of Neurological Surgery, University of Washington, Seattle, WA, United States2Department of Biostatistics, University of Washington, Seattle, WA, United StatesObjectiveMany active duty service members with mild traumatic brain injury (mTBI) report comorbidities such as depression, anxiety, PTSD, insomnia, and pain. We analyzed data from a prior randomized controlled trial (RCT) to examine the effects of evidence-based treatment modules, delivered by telephone, on the number and symptom burden of five common comorbidities.Setting and participants356 service members from two military medical centers who had sustained deployment-related mTBI in the preceding 2 years.DesignSecondary analysis of RCT comparing 6 months of telephone-delivered problem-solving treatment (PST) with comorbidity-specific modules to education only (EO).Main measuresComorbidity burden measured by Patient Health Questionnaire-9, Brief Symptom Inventory-Anxiety, PTSD Checklist, Pittsburgh Sleep Quality Inventory, Rivermead Postconcussion Symptoms Questionnaire (headache item) assessed at baseline and 6 and 12 months.Results47% of service members endorsed ≥ 3 comorbidities at baseline. At 6 months, the PST group had significantly fewer comorbidities, greater improvement in depression, anxiety, PTSD, and sleep, but not headache, and higher response/remission rates for depression and sleep, compared to EO. There were no significant group differences at 12 months.ConclusionTelephone-delivered PST with comorbidity-specific modules reduces burden of comorbidities after deployment-related mTBI. Research is needed on how to maintain improvements over time.https://www.frontiersin.org/articles/10.3389/fneur.2025.1594748/fulltraumatic brain injuryconcussioncomorbiditytelehealthclinical trial
spellingShingle Jesse R. Fann
Jesse R. Fann
Tessa Hart
Kathleen R. Bell
Wesley Cole
Sonia Jain
Rema Raman
Jason Barber
Sureyya Dikmen
Sureyya Dikmen
John Richardson
Murray B. Stein
Murray B. Stein
Murray B. Stein
Nancy Temkin
Nancy Temkin
Nancy Temkin
Effects of a modular telehealth intervention on comorbid conditions in service members with mild traumatic brain injury
Frontiers in Neurology
traumatic brain injury
concussion
comorbidity
telehealth
clinical trial
title Effects of a modular telehealth intervention on comorbid conditions in service members with mild traumatic brain injury
title_full Effects of a modular telehealth intervention on comorbid conditions in service members with mild traumatic brain injury
title_fullStr Effects of a modular telehealth intervention on comorbid conditions in service members with mild traumatic brain injury
title_full_unstemmed Effects of a modular telehealth intervention on comorbid conditions in service members with mild traumatic brain injury
title_short Effects of a modular telehealth intervention on comorbid conditions in service members with mild traumatic brain injury
title_sort effects of a modular telehealth intervention on comorbid conditions in service members with mild traumatic brain injury
topic traumatic brain injury
concussion
comorbidity
telehealth
clinical trial
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1594748/full
work_keys_str_mv AT jesserfann effectsofamodulartelehealthinterventiononcomorbidconditionsinservicememberswithmildtraumaticbraininjury
AT jesserfann effectsofamodulartelehealthinterventiononcomorbidconditionsinservicememberswithmildtraumaticbraininjury
AT tessahart effectsofamodulartelehealthinterventiononcomorbidconditionsinservicememberswithmildtraumaticbraininjury
AT kathleenrbell effectsofamodulartelehealthinterventiononcomorbidconditionsinservicememberswithmildtraumaticbraininjury
AT wesleycole effectsofamodulartelehealthinterventiononcomorbidconditionsinservicememberswithmildtraumaticbraininjury
AT soniajain effectsofamodulartelehealthinterventiononcomorbidconditionsinservicememberswithmildtraumaticbraininjury
AT remaraman effectsofamodulartelehealthinterventiononcomorbidconditionsinservicememberswithmildtraumaticbraininjury
AT jasonbarber effectsofamodulartelehealthinterventiononcomorbidconditionsinservicememberswithmildtraumaticbraininjury
AT sureyyadikmen effectsofamodulartelehealthinterventiononcomorbidconditionsinservicememberswithmildtraumaticbraininjury
AT sureyyadikmen effectsofamodulartelehealthinterventiononcomorbidconditionsinservicememberswithmildtraumaticbraininjury
AT johnrichardson effectsofamodulartelehealthinterventiononcomorbidconditionsinservicememberswithmildtraumaticbraininjury
AT murraybstein effectsofamodulartelehealthinterventiononcomorbidconditionsinservicememberswithmildtraumaticbraininjury
AT murraybstein effectsofamodulartelehealthinterventiononcomorbidconditionsinservicememberswithmildtraumaticbraininjury
AT murraybstein effectsofamodulartelehealthinterventiononcomorbidconditionsinservicememberswithmildtraumaticbraininjury
AT nancytemkin effectsofamodulartelehealthinterventiononcomorbidconditionsinservicememberswithmildtraumaticbraininjury
AT nancytemkin effectsofamodulartelehealthinterventiononcomorbidconditionsinservicememberswithmildtraumaticbraininjury
AT nancytemkin effectsofamodulartelehealthinterventiononcomorbidconditionsinservicememberswithmildtraumaticbraininjury