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“Mild Traumatic Brain Injury: Overlooked Rehabilitation Care Pathways”: an innovative initiative in XXX region to promote patient recovery

Félicité BEGUIN, Isabelle ONISKOFF, Audrey ABRIAL, Manon LAVIGNE, Manon RICHARD, Philippe AZOUVI and Mathilde CHEVIGNARD

Mild traumatic brain injury (mTBI) represents a public health challenge in terms of number of patients, of which 15–20% suffer persistent long-term symptoms, affecting resumption of daily activities. Authorized under Article 51 of the 2018 Social Security Financing Act, the pilot program “Mild traumatic brain injury: overlooked rehabilitation care pathways” began in March 2023.Very early patient identification from records of emergency department visit for mTBI, and organisation of appropriate follow-up and management, in order to promote rapid recovery and optimal return to family, social, and professional/school activities.Four units (three adult, one paediatric) have been deployed in XXX region, each comprising a coordinating nurse, an emergency department, and a Physical and Rehabilitation Medicine department. A network of private practitioners strengthens the links between hospital and community care. Coordinators identify patients through emergency department records or referral by a general practitioner. They contact patients 15 days post-mTBI (D15) for a telephone assessment and provide advice, reassurance, and psychoeducation regarding symptom management and activity regulation. Patients symptomatic at D15 are contacted again at D30. If difficulties persist, they are referred to a multidisciplinary clinic, which leads, if needed, to an 11-hour psychoeducation program delivered by mTBI expert healthcare professionals.Between March 2023 and October 2025, 4,429 patients were included; 3,461 (78%) were contacted at D15 and 737 (17%) at D30. A total of 168 patients were referred for multidisciplinary clinic, of whom 136 (3%) entered the psychoeducation program.This pilot program confirmed the high incidence of mTBI and the need for early evaluation and reassurance. It enables rapid, specific, and graded intervention. The number of psychoeducation programs delivered, far lower than expected based on data from the literature (485; 8%), suggests that very early support and reassurance may reduce persistence and impact of post-concussion symptoms.Results suggest that this intervention reduces anxiety, symptom persistence, and medical wandering. General practitioners can refer patients directly to this program, making them key stakeholders in this care pathway. An program evaluation in 2026 will determine if and how it could be implemented nationwide.