New Research Affirms the Importance of Biopsychosocial Care Management

Paradigm − June 12, 2017 − filed under Complex Case Management, Multiple Trauma

Physical therapist examining patientDavis, a young teacher, went out for a run one day and was struck from behind by a car doing 40 mph. He flew onto the hood of the car and his head smashed into the windshield before he cartwheeled and then landed on his forehead in the middle of the road. His recovery was slow, and as he said, “I went from being a teacher to having to learn the alphabet all over again.” But it was his struggle after acute recovery that was proving to be the hardest.

In a Reddit post about multiple traumas, he wrote, “I have come a long way in brain recovery since the accident, but there are just so many instances that seem like things will never get better. I wish I could get over it, but it just won’t leave me. Is there anything I can do?”

Comprehensive Care Beyond the Acute Phase

Davis was responding to an incisive research article in the journal Medicine by physicians from the Department of Orthopaedic and Trauma Surgery at the University of Freiburg Medical Center in Freiburg, Germany. The paper, “Lower Health-Related Quality of Life in Polytrauma Patients: Long Term Follow-Up After Over 5 Years,” argues that comprehensive, biophysical care must extend beyond the acute care phase for the best possible long-term outcomes.

Researchers gathered and assessed retrospective data from 384 polytraumatized patients. During a follow-up, 147 of those patients were further evaluated. This long-term examination of quality of life and changes in daily activity was achieved by applying five standard and validated scores, from the Glasgow Outcome Scale to Trauma Outcome Profile. Their findings were telling.

Treat More than Just the Physical Symptoms

For instance, in the PTSD category, five years or more after their injury, the incidence of PTSD for such patients still ranged between 18% and 42%. Other serious problems discovered in polytraumatized patients were changes in their job and socioeconomic situation. In the patients studied, 29% reported suffering a financial loss after their accidents. This was a very high percentage. And while 76% of patients were able to continue working at their original job, others had to change jobs or train for a new one, and 16% remained unemployed. Even more concerning was some working groups citing rates as high as 33% of severely injured patients who have lost their jobs.

“Even after five years, polytraumatized patients still suffer from persistent pain and function impairments,” the researchers concluded. “When rehabilitating these patients, it is not enough to just treat the injuries’ physical symptoms. Their emotional consequences should also be identified, as they are apt to benefit from long-term therapy.”

Paradigm’s Approach to Long-Term Care and Better Outcomes

At Paradigm Outcomes, we likewise understand the challenges these patients face. That’s why we created a proprietary Systematic Care ManagementSM methodology for case management. This unique program utilizes a comprehensive care plan that addresses both biophysical and psychosocial-behavioral elements. Our teams work with providers across the care continuum to achieve the highest possible functional recovery by the injured worker. Because catastrophic injury claims are highly complex, our approach supplements the treating medical team with a coordinated safety net to help mitigate medical errors, missed information, inconsistencies between provider practices and general fragmentation of care.

“The Freiburg study demonstrates and corroborates the importance of a comprehensive injured worker-centric care plan that addresses the whole person—both biophysical and psychological/emotional facets,” said Michael Choo, MD, Paradigm’s Chief Medical Officer.  “With a dedicated team of expert physicians, onsite nurse case managers, and specialized clinical leadership, we’ve long followed the researchers’ recommendations and  deliver five times better medical outcomes compared to industry benchmarks.”

Focus on the Injured Worker

Davis’s cry for help didn’t go unanswered in the post. A “PTSD/depression researcher” suggested he reach out to his rehabilitation facility to see if they had any referrals for

psychologists who specialized in traumatic brain injury. While this was a good first step for Davis, the research shows that complex injuries like his require treatment for psychological and social needs, as well as the physical symptoms, for better quality of life.

Short-term treatments are rarely a strategy for long-term success. Only a comprehensive care plan can provide substantive and lasting outcomes for patients suffering from catastrophic injuries.

To learn more about Paradigm Outcomes’ Systematic Care ManagementSMapproach, visit our website or follow us on Facebook, Twitter, and LinkedIn.

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