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Pediatric Patient Compliance With Recommendations for Acute Concussion Management

Jeremy M Root1, Brittany McNamara1,2, Matt Ledda1,3

  • 11 Children's National Health System, Washington, DC, USA.

Clinical Pediatrics
|April 2, 2019
PubMed

Insights

Pediatric concussion management is evolving. This study found that physician recommendations for time off school after a concussion did not significantly impact how long students actually stayed home, questioning current practices.

Area of Science:

  • Pediatric Emergency Medicine
  • Neurology
  • Sports Medicine

Background:

  • Emerging evidence supports active management for acute pediatric concussions.
  • Current practices of pediatric emergency providers for acute concussion management are not well-documented.

Purpose of the Study:

  • To assess pediatric emergency provider recommendations for time off school and sports after acute concussion.
  • To evaluate patient compliance with these recommendations.
  • To question the influence of physician recommendations on acute pediatric concussion management.

Main Methods:

  • Prospective enrollment of 134 pediatric patients with acute concussion.
  • Real-time provider surveys to record recommendations for time off school and sports.
  • Assessment of patient compliance with recommendations 7–10 days post-injury.

Main Results:

  • 35.1% of providers recommended moderate time off from school.
  • Patient compliance with "moderate time off" recommendations showed no significant difference compared to "minimal rest" recommendations (31.8% vs 32.5% taking >2 days off).
  • Physician recommendations did not significantly influence the actual time patients took off from school.

Conclusions:

  • A significant proportion of pediatric emergency providers still recommend moderate time off from school for concussions.
  • Patient adherence to physician recommendations for time off school after concussion is questionable.
  • The influence of physician recommendations on the actual management of acute pediatric concussions needs further investigation.

Keywords:
complianceconcussionrest

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