Firearm injury prevention counseling for patients with traumatic brain injury: a survey of brain injury physicians

Ian Ramsay; Natalia Del Mar Miranda-Cantellops; Oliver Acosta; Lauren T Shapiro

doi:10.3389/fneur.2023.1237095

Firearm injury prevention counseling for patients with traumatic brain injury: a survey of brain injury physicians

Front Neurol. 2023 Aug 24:14:1237095. doi: 10.3389/fneur.2023.1237095. eCollection 2023.

Authors

Ian Ramsay¹, Natalia Del Mar Miranda-Cantellops², Oliver Acosta³, Lauren T Shapiro⁴

Affiliations

¹ MD/MPH Program, University of Miami Leonard M. Miller School of Medicine, Miami, FL, United States.
² Brain Injury Fellowship Program, Shepherd Center, Atlanta, GA, United States.
³ Physical Medicine & Rehabilitation Residency Program, University of Miami/Jackson Health System, Miami, FL, United States.
⁴ Department of Physical Medicine & Rehabilitation, University of Miami Leonard M. Miller School of Medicine, Miami, FL, United States.

Abstract

Background: Survivors of traumatic brain injury are at increased risk for firearm-related injuries, including suicide.

Aims: To determine current practices of Brain Injury Medicine (BIM) physicians and their rehabilitation teams in assessing patients' access to firearms and in providing firearm safety education, and the impact of having received training on this topic on physicians' likelihood of inquiring about patients' access to firearms.

Methods: 14-item web-based cross-sectional survey of 86 U.S. physiatrists board-certified in BIM.

Results: 81% of respondents indicated they believe BIM physicians should counsel their patients on firearm safety but only 12.9% reported always doing so. Fifteen percent reported always inquiring about their patients' access to firearms. 88.2% indicated having never received formal training on firearm injury prevention counseling. Physicians who received such training had 7.5 times higher odds of reporting at least sometimes inquiring about patients' access to firearms than those who were not trained [95% confidence interval (1.94, 28.64)]. They also had 5.7 times higher odds for reporting being at least moderately comfortable providing patients firearm safety counseling [95% CI: (1.39, 23.22)].

Conclusion: While most BIM specialists who responded to this survey believe they should counsel patients on firearm safety, few always or usually do so. Moreover, most do not routinely inquire about their patients' access to firearms. The provision of firearm injury prevention training to BIM physicians was strongly associated with an increased likelihood they will inquire about their patients' access to guns and with an improved comfort level in providing counseling on this subject matter.

Keywords: brain injury medicine; firearms; gun violence; patient safety; traumatic brain injury.