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COMPLIANCE RATES AND SYMPTOM EXACERBATION FOR THE MOBILE NEUROCOGNITIVE HEALTH (MNCH) PROJECT IN ADOLESCENTS AND ADULTS WITH CONCUSSION

Abstract

R.J. Elbin1, Kori Durfee1, Melissa N. Womble2, Christina M. Dollar2, Daniel B. Elbich3 and Jonathan G. Hakun3

1University of Arkansas, Fayetteville, AR

2Inova Sports Medicine Concussion Program

3Pennsylvania State University, State College, PA

The Mobile Neurocognitive Health project (MNCH) is an ambulatory assessment study that measures how concussion symptoms and impairments evolve and change throughout the daily lives of patients. Patients with concussion respond on their smartphones to four daily assessment notifications over a 7-day period to complete cognitive assessments, as well as report symptoms and information on environmental exposures. Study compliance and the potential exacerbation of concussion symptoms from participation is unknown.

PURPOSE: 1) To document compliance for the MNCH protocol in participants with concussion, and 2) to investigate the prevalence of acute symptom exacerbation upon completion of the MNCH assessments

METHODS: 123 participants (M=19.91, SD=8.60 yrs, 67% female) with a concussion downloaded the smart phone application at their first clinical visit (M=4.31, SD=1.56 days) and received 4 assessment notifications daily at 6:00am, 10:00am, 2:30pm, and 8:00pm for the 7 days after their clinic visit. Participants completed a brief cognitive assessment (~3mins), and surveys assessing symptom reactivity to environmental exposure. Participants indicated any symptom exacerbation (“Completing the assessments made my symptoms worse”) via a 100-pt visual analog slider (0-“Not at All” to 100-“Extremely”) after completing each daily assessment. At the conclusion of study participation, a study acceptability survey was administered to all participants. Descriptive statistics were used to document compliance, post-survey symptom exacerbation scores, and study acceptability ratings.

RESULTS: The overall median compliance rate for the protocol was 71%. Median compliance was slightly lower for the 6:00am notification (57%) compared to the 71% observed for other three notifications. The average symptom exacerbation score was 32.49 (SD=23.95). Ninety-five percent (94/99) of participants reported that the app was easy to use and 80% (79/99) reported that the protocol did not interfere with daily life. Eighty-four percent (83/99) would recommend study participation to a friend.

CONCLUSIONS: A one-week implementation of a daily ambulatory assessment of cognition, symptom reactivity, and environmental exposure does not exacerbation concussion symptoms and is appropriate for this patient population.

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