IMPRESS: Pilot Study of a Multidisciplinary Intervention in ICU Survivors at Risk for Psychological or Physical Morbidity
Study Details
Study Description
Brief Summary
Pilot study of the feasibility and utility of an early, in-hospital multidisciplinary intervention in ICU survivors at risk for psychological and physical problems post-ICU stay
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
60 adult patients at three hospitals in Region Stockholm (Karolinska University Hospital, Södersjukhuset and Capio S:t Görans Hospital) with an ICU stay ≥12 hours. Exclusion criteria are dementia, structural brain or spinal cord injury and multiple limitations of medical treatment.
Eligibility screening: Patients with an increased risk for physical disability or psychological morbidity three months after ICU discharge (assessed with the PROGRESS-ICU/PREPICS instruments) will be invited to participate.
Intervention: Early re-assessment and multidisciplinary follow-up, led by an ICU follow-up staff (Case Manager, CM). The CM will support the patient and coordinate the rehabilitation efforts from ICU discharge to primary care with a secondary, deepened assessment of symptoms in the ward, recapitulation and information about the time spent in the ICU, followed by a multidisciplinary discussion with concerned specialists and the set-up of an individual rehabilitation plan communicated to the patient and the informal caregivers. The CM will keep track of the patient during hospital stay and ensure that there is a plan for further primary care rehabilitation after hospital discharge. The CM will contact the patient weekly to follow up on wellbeing and planned primary care activities until 12 weeks. At twelve weeks, patients will be assessed with regards to psychological symptoms (HADS, PTSS-14) and physical disability (BI).
Outcome: The primary outcome is the feasibility of the intervention. Patients and informal caregivers will be invited to participate in focus groups where semi-structured interviews will deepen the knowledge about their needs and suggested measures to improve the patients' recovery. Resource utilisation will be documented by the CM and feedback collected from hospital clinicians and primary care providers. Secondary outcome is patients' level of psychological and physical problems.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Interventional arm Intervention arm |
Other: Case-manager led multidisciplinary follow-up after intensive care
Early in-hospital follow-up in survivors of intensive care with an increased risk of psychological/physical sequelae. The follow-up is led by a case-manager reassessing the patient after ICU discharge for psychological/physical rehabilitation needs. The CM will discuss patient needs with concerned specialists in a multidisciplinary team, leading to the establishment of a personal rehabilitation plan, communicated to the patient and next-of-kin. The CM will keep track of the patient during hospital stay and ensure primary care rehabilitation (if needed) is established once the patient is discharged from the hospital. The CM will contact the patient weekly to follow up on well-being and primary care activities until 12 weeks after discharge.
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Outcome Measures
Primary Outcome Measures
- Feasibility of the intervention [Outcome measured during and after termination of data collection and end of intervention]
Evaluation of the method including resource utilization with involved ICU follow-up staff/case managers and patients and their informal caregivers.
- Utility of the intervention [Outcome measured three-four months after ICU discharge]
Patient and caregiver views on the intervention's utility. Views on the intervention from hospital ward staff.
Secondary Outcome Measures
- Depressive symptoms post-ICU [Outcome measured three months after ICU discharge]
Assessment of patients' symptoms of depression post-intervention
- Anxiety symptoms post-ICU [Outcome measured three months after ICU discharge]
Assessment of patients' symptoms of anxiety post-intervention
- Symptoms of post-traumatic stress post-ICU [Outcome measured three months after ICU discharge]
Assessment of patients' symptoms of post-traumatic stress post-intervention
- Physical disability post-ICU [Outcome measured three months after ICU discharge]
Assessment of physical performance post-intervention
Eligibility Criteria
Criteria
Inclusion Criteria:
- Patients admitted ≥12 hours to the ICU with an increased risk for physical or psychological sequelae (assessed with the PROGRESS-ICU instruments)
Exclusion Criteria:
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Dementia or other major cognitive problems
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Structural brain or spinal cord injury
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Multiple limitations of medical treatment
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Region Stockholm
Investigators
- Principal Investigator: Anna Milton, Karolinska Institutet/Karolinska University Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 2022-03436-01