New national recommendations boost care for traumatic brain injury patients

Traumatic brain injury, or TBI, affects millions of Americans each year, often resulting in long-term health challenges. New national recommendations are now paving the way for more effective short- and long-term care for patients with TBI.

Monica Verduzco-Gutierrez, MD, a physiatrist with UT Health San Antonio, the academic health center of The University of Texas at San Antonio, and professor and chair of the Department of Physical Medicine and Rehabilitation at UT San Antonio's Long School of Medicine, served on the National Academies of Sciences, Engineering and Medicine working group that wrote the updated guidelines for diagnosing, monitoring and rehabilitation of individuals with traumatic brain injury.

This is the most comprehensive update in more than a decade and provides new strategies for patient follow-up care beyond the acute phase, especially for individuals who did not require hospitalization.

We know that even TBIs not requiring hospitalization can lead to long-term symptoms and disability, and traditional classifications like 'mild' often fail to capture the complexity of these injuries."

Monica Verduzco-Gutierrez, MD, Physiatrist, University of Texas Health Science Center at San Antonio

The updated guidelines were published in September in both the Annals of Family Medicine and the Journal of Neurotrauma.

"Updating the clinical practice guidelines for outpatient traumatic brain injury care was essential to address the wide variability and gaps in follow-up care that patients often experience. Less than half of patients receive any form of follow-up," Verduzco-Gutierrez said.

The Clinical Practice Guideline Working Group reviewed the latest evidence on brain injury care to establish standards that hospitals, rehabilitation centers, and outpatient clinics can apply across the country.

The new guidelines call for structured follow-up, early referral to rehabilitation, and attention to cognitive, mood, and functional changes that may develop after TBI. The recommendations include approaches that primary care providers can use to recognize when patients may need additional support or referral to a specialist.

Verduzco-Gutierrez said one of the most important updates is the call for health professionals to screen all TBI patients for health-related social needs such as food, housing, transportation and financial insecurity. These factors can directly impact whether patients are able to attend follow-up visits, access medications, or continue rehabilitation.

"If we don't identify and address these barriers, even the best medical plan can fall short," she said.

The guidelines are intended to improve TBI outpatient care for individuals with any level of severity and from any cause, whether or not hospitalization was required. They also include specific considerations for older adults, athletes, military service members and survivors of intimate partner violence.

"These new guidelines offer practical, evidence-informed strategies that empower primary care providers to deliver more consistent, equitable and effective care. This will ultimately improve outcomes for millions of individuals living with TBI," Verduzco-Gutierrez said.