Abstract

BACKGROUND: We report findings from an intervention study using telehealth modalities to determine whether provision of telehealth services can improve access to care and increase adherence to cognitive therapy in veterans with mild traumatic brain injury (TBI) while matching traditional care in terms of outcomes.

MATERIAL AND METHODS: Veterans who were initially non-adherent to clinic-based cognitive therapy were offered a newly developed treatment. The control participants were selected from patient records of veterans who had completed cognitive treatment and matched to MOPS-VI participants on the basis of age, marital or relationship status, and composite memory index score. Baseline and post-treatment cognitive functioning as assessed by the Test of Memory and Learning 2nd Edition (TOMAL-2) was obtained for all participants. The MOPS-VI modules were designed to increase understanding of TBI and elicit problem-solving skills for attention and memory impairment.

RESULTS: Sixty-seven percent of veterans (who were assigned to the MOPS-VI treatment group because they were initially non-adherent with the clinic-based treatment) completed the MOPS-VI telemedicine treatment. Results of a two-way analysis of Variance (ANOVA) comparing baseline and follow-up scores on the TOMAL-2 in the MOPS-VI and control groups revealed there was a significant pre-post assessment effect, indicating that participant’s memory and learning improved after treatment for both MOPS-VI and standard treatment groups. There was no significant difference between clinic-based treatment and MOPS-VI therapy.

CONCLUSIONS: Preliminary evidence supports the efficacy of the treatment, defined as increased compliance in completing the treatment program, and improvements in standardized memory and learning test results comparable to those following clinic-based treatment.

Keywords: Military Personnel, Patient Compliance, Internet, Cognitive Therapy, Cognition - physiology, Case-Control Studies, Analysis of Variance, Problem Solving, Telemedicine - methods, Veterans