1
|
Daugherty J, Peterson A, Waltzman D, Breiding M, Chen J, Xu L, DePadilla L, Corrigan JD. Rationale for the Development of a Traumatic Brain Injury Case Definition for the Pilot National Concussion Surveillance System. J Head Trauma Rehabil 2024; 39:115-120. [PMID: 38039498 DOI: 10.1097/htr.0000000000000900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
BACKGROUND Current methods of traumatic brain injury (TBI) morbidity surveillance in the United States have primarily relied on hospital-based data sets. However, these methods undercount TBIs as they do not include TBIs seen in outpatient settings and those that are untreated and undiagnosed. A 2014 National Academy of Science Engineering and Medicine report recommended that the Centers for Disease Control and Prevention (CDC) establish and manage a national surveillance system to better describe the burden of sports- and recreation-related TBI, including concussion, among youth. Given the limitations of TBI surveillance in general, CDC took this recommendation as a call to action to formulate and implement a robust pilot National Concussion Surveillance System that could estimate the public health burden of concussion and TBI among Americans from all causes of brain injury. Because of the constraints of identifying TBI in clinical settings, an alternative surveillance approach is to collect TBI data via a self-report survey. Before such a survey was piloted, it was necessary for CDC to develop a case definition for self-reported TBI. OBJECTIVE This article outlines the rationale and process the CDC used to develop a tiered case definition for self-reported TBI to be used for surveillance purposes. CONCLUSION A tiered TBI case definition is proposed with tiers based on the type of sign/symptom(s) reported the number of symptoms reported, and the timing of symptom onset.
Collapse
Affiliation(s)
- Jill Daugherty
- Author Affiliations: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, Georgia (Drs Daugherty, Peterson, Waltzman, Breiding, Chen, Xu, and DePadilla); and Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus (Dr Corrigan)
| | | | | | | | | | | | | | | |
Collapse
|
2
|
de Souza NL, Kumar RG, Pruyser A, Blunt EE, Sanders W, Meydan A, Lawrence P, Venkatesan UM, Mac Donald CL, Hoffman JM, Bodien YG, Edlow BL, Dams-O'Connor K. Intimate Partner Violence and Other Trauma Exposures in Females With Traumatic Brain Injury. J Neurotrauma 2024; 41:529-536. [PMID: 37974411 PMCID: PMC10837032 DOI: 10.1089/neu.2023.0225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
We examined whether females with a history of traumatic brain injury (TBI) and intimate partner violence (IPV) have greater exposure to lifetime trauma relative to females with TBI but no IPV history. Further, we assessed the effects of lifetime trauma on psychological outcomes after TBI. Female participants (n = 70; age M [standard deviation-SD] = 50.5 [15.2] years) with TBI (time since injury median [interquartile range -IQR] = 10.2 [5.3-17.8] years) completed a structured assessment of lifetime history of TBI, including an IPV module to query head injuries from physical violence by an intimate partner. We characterized lifetime trauma exposure with the Adverse Childhood Experiences (ACEs) questionnaire and Survey of Exposure to Community Violence (CV). We evaluated psychological functioning with self-report questionnaires of post-traumatic stress disorder (PTSD), depression, and anxiety symptoms. Compared with those with no IPV history (n = 51), participants reporting IPV-related head injuries (n = 19; 27.1%) reported more ACEs (M[SD] IPV: 4.5[2.9]; No IPV: 1.6[1.8], p < 0.001, d = 1.08) and greater CV (IPV: 17.5[8.4]; No IPV: 7.6[6.1], p < .0001, d = 1.26). Within the full sample, ACEs (β = 0.21, 95% confidence interval [CI] = 0.04-0.39) and CV (β = 0.07, 95% CI = 0.01-0.13) predicted worse PTSD symptoms, while IPV alone did not. Exposure to all three sources of trauma (ACEs, CV, and IPV) was associated with worse PTSD symptoms relative to fewer traumas. The results highlight the scope of traumatic exposures among TBI survivors and the importance of considering IPV and other lifetime trauma exposure in assessing and managing TBI. Trauma-informed interventions that are modified for TBI-related impairment may offer improved outcomes in managing psychological symptoms.
Collapse
Affiliation(s)
- Nicola L. de Souza
- Department of Rehabilitation and Human Performance and Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Raj G. Kumar
- Department of Rehabilitation and Human Performance and Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ariel Pruyser
- Department of Rehabilitation and Human Performance and Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Emily E. Blunt
- Department of Rehabilitation and Human Performance and Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - William Sanders
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
| | - Anogue Meydan
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Phoebe Lawrence
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Umesh M. Venkatesan
- Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania, USA
- Department of Rehabilitation Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania USA
| | - Christine L. Mac Donald
- Department of Neurological Surgery and University of Washington School of Medicine, Seattle, Washington, USA
| | - Jeanne M. Hoffman
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Yelena G. Bodien
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Charlestown, Massachusetts, USA
| | - Brian L. Edlow
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Kristen Dams-O'Connor
- Department of Rehabilitation and Human Performance and Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| |
Collapse
|
3
|
Snow C, Baldwin B, Hurst M, Colantonio A, Mollayeva T. Utility of Person-Environment-Occupation model in exploring sex-specific causes of work-related traumatic brain injury: a retrospective chart review. Brain Inj 2023; 37:485-493. [PMID: 36919536 DOI: 10.1080/02699052.2023.2187087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Work-related traumatic brain injury (wr-TBI) is on the rise. The pre-injury period, a significant consideration for preventive initiatives, is largely unexplored. OBJECTIVES To identify Person-Environment-Occupation (PEO) variables associated with wr-TBI to inform sex-specific primary prevention. METHODS Retrospective chart review data were analyses. Two-tailed t-test and chi-squared tests were used to study sex differences. Multivariate logistic regression models of wr-TBI were fit with a priori defined PEO variables. RESULTS The sample comprised 330 consecutive workers with wr-TBI (40.8 ± 11.1 years old, 71% male). Sex differences were observed across PEO variables. In multivariable logistic regression analyses the odds of sustaining a wr-TBI from a fall increased with the presence of a mood disorder and participation in non-labourer occupations (odds ratio (OR) 2.89 (95% CI 1.06-7.89) and OR 2.89 (95% CI 1.06-7.89), respectively) and decreased being a male (OR 0.31 (95% CI 0.17-0.54)). The odds of sustaining a wr-TBI from being striken by an object was greater in workers with prior head injury (OR 2.8 (95% CI 1.24-6.45)). None of the variables studied were associated with wr-TBI sustained from being striken against an object. CONCLUSIONS Workers' health status pre-injury is associated with external causes of wr-TBI. Sex differences across PEO categories warrant further study.
Collapse
Affiliation(s)
- Cori Snow
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada
| | - Bristol Baldwin
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada
| | - Mackenzie Hurst
- KITE Toronto Rehabilitation Institute University Health Network, Toronto, Canada
| | - Angela Colantonio
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Tatyana Mollayeva
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada.,KITE Toronto Rehabilitation Institute University Health Network, Toronto, Canada.,Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| |
Collapse
|
4
|
Chan V, Toccalino D, Omar S, Shah R, Colantonio A. A systematic review on integrated care for traumatic brain injury, mental health, and substance use. PLoS One 2022; 17:e0264116. [PMID: 35239715 PMCID: PMC8893633 DOI: 10.1371/journal.pone.0264116] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 02/03/2022] [Indexed: 12/22/2022] Open
Abstract
Traumatic brain injuries (TBI) and mental health or substance use disorders (MHSU) are global public health concerns due to their prevalence and impact on individuals and societies. However, care for individuals with TBI and MHSU remains fragmented with a lack of appropriate services and supports across the continuum of healthcare. This systematic review provided an evidence-based foundation to inform opportunities to mobilize and adapt existing resources to integrate care for individuals with TBI and MHSU by comprehensively summarizing existing integrated activities and reported barriers and facilitators to care integration. MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, Sociological Abstracts, and Dissertations & Theses Global were independently reviewed by two reviewers based on pre-determined eligibility criteria. Data on the integration activity, level and type of integration, reported barriers and facilitators, and the strategies aligning with the World Health Organization’s (WHO) Framework on Integrated Person-Centred Care were extracted to form the basis for a narrative synthesis. Fifty-nine peer-reviewed articles were included, describing treatments (N = 49), programs (N = 4), or screening activities (N = 7). Studies discussing clinical integration at the micro- (N = 38) and meso- (N = 10) levels, service integration at the micro- (N = 6) and meso- (N = 5) levels, and functional integration at the meso-level (N = 1) were identified. A minority of articles reported on facilitators (e.g., cognitive accommodations in treatment plans; N = 7), barriers (e.g., lack of education on cognitive challenges associated with TBI; N = 2), or both (N = 6), related to integrating care. This review demonstrated that integrated TBI and MHSU care already exists across a range of levels and types. Given the finite and competing demands for healthcare resources, cognitive accommodations across treatment plans to facilitate integrated TBI and MHSU care should be considered. Multidisciplinary teams should also be explored to provide opportunities for education among health professionals so they can be familiar with TBI and MHSU. Trial registration: Prospero Registration: CRD42018108343.
Collapse
Affiliation(s)
- Vincy Chan
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
| | - Danielle Toccalino
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Samira Omar
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Riya Shah
- Department of Health and Society, University of Toronto Scarborough, Scarborough, Ontario, Canada
- Department of Psychology, University of Toronto Scarborough, Scarborough, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Angela Colantonio
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
5
|
Olsen CM, Corrigan JD. Does Traumatic Brain Injury Cause Risky Substance Use or Substance Use Disorder? Biol Psychiatry 2022; 91:421-437. [PMID: 34561027 PMCID: PMC8776913 DOI: 10.1016/j.biopsych.2021.07.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/07/2021] [Accepted: 07/12/2021] [Indexed: 01/22/2023]
Abstract
There is a high co-occurrence of risky substance use among adults with traumatic brain injury (TBI), although it is unknown if the neurologic sequelae of TBI can promote this behavior. We propose that to conclude that TBI can cause risky substance use, it must be determined that TBI precedes risky substance use, that confounders with the potential to increase the likelihood of both TBI and risky substance use must be ruled out, and that there must be a plausible mechanism of action. In this review, we address these factors by providing an overview of key clinical and preclinical studies and list plausible mechanisms by which TBI could increase risky substance use. Human and animal studies have identified an association between TBI and risky substance use, although the strength of this association varies. Factors that may limit detection of this relationship include differential variability due to substance, sex, age of injury, and confounders that may influence the likelihood of both TBI and risky substance use. We propose possible mechanisms by which TBI could increase substance use that include damage-associated neuroplasticity, chronic changes in neuroimmune signaling, and TBI-associated alterations in brain networks.
Collapse
Affiliation(s)
- Christopher M Olsen
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin; Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin; Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - John D Corrigan
- Department of Physical Medicine & Rehabilitation, Wexner Medical Center, The Ohio State University, Columbus, Ohio
| |
Collapse
|
6
|
Feiss R, Corrigan JD, Ding K, Beaulieu CL, Bogner J, Yang J. Rural-Urban Differences in Behavioral Outcomes among Adults with Lifetime History of Traumatic Brain Injury with Loss of Consciousness: 2016-2019 Ohio BRFSS. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031678. [PMID: 35162700 PMCID: PMC8835472 DOI: 10.3390/ijerph19031678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/03/2021] [Accepted: 01/30/2022] [Indexed: 02/04/2023]
Abstract
This study examined if the associations between lifetime history of traumatic brain injury (TBI) with loss of consciousness (LOC) and unhealthy alcohol use or mental health problems differ by location of living (rural vs. urban). The lifetime history data of TBI with LOC, location of living, unhealthy alcohol use (binge drinking, heavy drinking), and mental health problems (depression diagnosis, number of poor mental health days) were sourced from the 2016, 2017, 2018, and 2019 Ohio Behavioral Risk Factory Surveillance Surveys, and the final sample included 16,941 respondents. We conducted multivariable logistic regressions to determine the odds ratios for each of the five outcomes between individuals living in rural vs. urban areas and between individuals with vs. without a lifetime history of TBI with LOC. No interaction between location of living and lifetime history of TBI with LOC was observed for any outcomes, indicating rurality did not modify these relationships. Living in a rural area was associated with decreased binge drinking or heavy drinking but not mental health outcomes. Lifetime history of TBI with LOC was associated with an increased risk of binge drinking, heavy drinking, depression diagnoses, and poor general mental health, regardless of location of living. Our findings support the need for TBI screenings as part of mental health intake evaluations and behavioral health screenings. Though rurality was not associated with mental health outcomes, rural areas may have limited access to quality mental health care. Therefore, future research should address access to mental health services following TBI among rural residents.
Collapse
Affiliation(s)
- Robyn Feiss
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43215, USA;
| | - John D. Corrigan
- Division of Rehabilitation Psychology, Department of Physical Medicine and Rehabilitation, College of Medicine, The Ohio State University, Columbus, OH 43210, USA; (J.D.C.); (C.L.B.); (J.B.)
| | - Kele Ding
- Department of Health Sciences, Kent State University, Kent, OH 44240, USA;
| | - Cynthia L. Beaulieu
- Division of Rehabilitation Psychology, Department of Physical Medicine and Rehabilitation, College of Medicine, The Ohio State University, Columbus, OH 43210, USA; (J.D.C.); (C.L.B.); (J.B.)
| | - Jennifer Bogner
- Division of Rehabilitation Psychology, Department of Physical Medicine and Rehabilitation, College of Medicine, The Ohio State University, Columbus, OH 43210, USA; (J.D.C.); (C.L.B.); (J.B.)
| | - Jingzhen Yang
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43215, USA;
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Correspondence:
| |
Collapse
|
7
|
Choi Y, Kim EY, Sun J, Kim HK, Lee YS, Oh BM, Park HY, Leigh JH. Incidence of Depression after Traumatic Brain Injury: A Nationwide Longitudinal Study of 2.2 Million Adults. J Neurotrauma 2021; 39:390-397. [PMID: 34931535 PMCID: PMC8892960 DOI: 10.1089/neu.2021.0111] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Although improvements in acute care for traumatic brain injury (TBI) have increased the patient survival rate, many survivors often suffer from neuropsychiatric sequelae such as depression. This study investigated the influence of TBI on the risk of depression using South Korean nationwide data. Data were extracted from the National Health Insurance Service database for patients who experienced TBI from 2010 to 2017 (n = 1,141,593) and for 1:1 matched controls without TBI (n = 1,141,593). Patients under 18 years old or with a history of depression were excluded. TBI was used as a time-varying exposure and a time-dependent Cox regression model was adopted. Age, sex, insurance premium and type, region of residence, past psychiatric diseases, and Charlson Comorbidity Index were adjusted. The incidence of depression in the patients with TBI and matched controls was 34.60 and 21.42 per 1000 person-years, respectively. The risk of depression was higher in the patients with TBI (hazard ratio [HR] 1.19, 95% confidence interval [CI] = 1.18-1.20) than in the matched control group. After stratification by sex and age, the risk was higher in men and the younger age group. In subgroup analyses, patients with skull fracture showed the highest risk of depression. Notably, during the first year after TBI, the depression risk was almost 11 times higher than that in the matched control group (HR 11.71, 95% CI = 11.54-11.87). Our findings highlight a significant association of TBI with an increased risk of subsequent depression. Therefore, continuous awareness with regard to patients' mental health is needed.
Collapse
Affiliation(s)
- Yoonjeong Choi
- Seoul National University Hospital, 58927, Jongno-gu, Seoul, Korea (the Republic of);
| | - Eun Young Kim
- Seoul National University College of Medicine, 37990, Seoul, Korea (the Republic of);
| | - Jiyu Sun
- SNU SMG Boramae Medical Center, 65633, Dongjak-gu, Seoul, Korea (the Republic of);
| | - Han-Kyoul Kim
- Seoul National University Hospital, 58927, Department of Rehabilitation Medicine, Jongno-gu, Seoul, Korea (the Republic of);
| | - Ye Seol Lee
- Seoul National University Hospital, 58927, Jongno-gu, Seoul, Korea (the Republic of);
| | - Byung-Mo Oh
- Seoul National University Hospital, 58927, Department of Rehabilitation Medicine, 101 Daehak-ro Chongno-gu, Seoul, Korea (the Republic of), 03080;
| | - Hye Yoon Park
- Seoul National University Hospital, 58927, Jongno-gu, Seoul, Korea (the Republic of);
| | - Ja-Ho Leigh
- Seoul National University Hospital, 58927, 101 Daehak-ro, Jongno-gu, Korea (the Republic of), 03080;
| |
Collapse
|
8
|
Daugherty J, Sarmiento K, Womack LS, Breiding M. Symptom profile of affirmative responses to a self-report concussion question, United States 2019. Brain Inj 2021; 35:1413-1417. [PMID: 34487455 PMCID: PMC8678211 DOI: 10.1080/02699052.2021.1972340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/19/2021] [Accepted: 08/20/2021] [Indexed: 10/20/2022]
Abstract
Information is limited about signs and symptoms experienced by individuals who self-report a concussion within surveys. The objective of this study was to assess the number and types of signs/symptoms adults experienced and whether or not medical attention was reported after sustaining a self-reported concussion in the past year. A sample of 3,624 adults responded to the web-based 2019 FallStyles survey. Respondents were asked if they had sustained a concussion in the past 12 months and if so, which (if any) signs/symptoms they experienced following the injury. The frequency and percentages of symptoms were calculated. Approximately 2.9% of respondents reported a concussion in the past year. Approximately two-thirds of respondents who reported sustaining a recent concussion stated that they experienced two or more signs/symptoms; the remaining one-third reported zero or one symptom. The findings suggest self-report concussion questions need additional improvement, particularly those that capture concussion using a single question, to improve the validity of self-reports.
Collapse
Affiliation(s)
- Jill Daugherty
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA, USA
| | - Kelly Sarmiento
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA, USA
| | - Lindsay S Womack
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA, USA
| | - Matthew Breiding
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA, USA
| |
Collapse
|
9
|
Association of Lifetime History of Traumatic Brain Injury With Prescription Opioid Use and Misuse Among Adults. J Head Trauma Rehabil 2021; 36:328-337. [PMID: 34489383 DOI: 10.1097/htr.0000000000000729] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate associations of lifetime history of traumatic brain injury (TBI) with prescription opioid use and misuse among noninstitutionalized adults. PARTICIPANTS Ohio Behavioral Risk Factor Surveillance System (BRFSS) participants in the 2018 cohort who completed the prescription opioid and lifetime history of TBI modules (n = 3448). DESIGN Secondary analyses of a statewide population-based cross-sectional survey. MAIN MEASURES Self-report of a lifetime history of TBI using an adaptation of the Ohio State University TBI-Identification Method. Self-report of past year: (1) prescription pain medication use (ie, prescription opioid use); and (2) prescription opioid misuse, defined as using opioids more frequently or in higher doses than prescribed and/or using a prescription opioid not prescribed to the respondent. RESULTS In total, 22.8% of adults in the sample screened positive for a lifetime history of TBI. A quarter (25.5%) reported past year prescription opioid use, and 3.1% met criteria for prescription opioid misuse. A lifetime history of TBI was associated with increased odds of both past year prescription opioid use (adjusted odds ratio [AOR] = 1.52; 95% CI, 1.27-1.83; P < .01) and prescription opioid misuse (AOR = 1.65; 95% CI, 1.08-2.52; P < .05), controlling for sex, age, race/ethnicity, and marital status. CONCLUSION Results from this study support the "perfect storm" hypothesis-that persons with a history of TBI are at an increased risk for exposure to prescription opioids and advancing to prescription opioid misuse compared with those without a history of TBI. Routine screening for a lifetime history of TBI may help target efforts to prevent opioid misuse among adults.
Collapse
|