Evaluation of a Health and Social Care Programme to Improve Outcomes Following Critical Illness: a Multicentre Study

Overview

Journal Thorax

Date 2022 Mar 22

PMID 35314485

Authors

Philip Henderson

Tara Quasim

Martin Shaw

Pamela MacTavish

Helen Devine

Malcolm Daniel

Fiona Nicolson

Peter OBrien

Ashley Weir

Laura Strachan

Lorraine Senior

Phil Lucie

Lynn Bollan

Jane Duffty

Lucy Hogg

Colette Ross

Malcolm Sim

Radha Sundaram

Theodore J Iwashyna

Joanne McPeake

Affiliations

Soon will be listed here.

Abstract

Rationale: At present, clinicians aiming to support patients through the challenges after critical care have limited evidence to base interventions.

Objectives: Evaluate a multicentre integrated health and social care intervention for critical care survivors. A process evaluation assessed factors influencing the programme implementation.

Methods: This study evaluated the impact of the Intensive Care Syndrome: Promoting Independence and Return to Employment (InS:PIRE) programme. We compared patients who attended this programme with a usual care cohort from the same time period across nine hospital sites in Scotland. The primary outcome was health-related quality of life (HRQoL) measured via the EuroQol 5-dimension 5-level instrument, at 12 months post hospital discharge. Secondary outcome measures included self-efficacy, depression, anxiety and pain.

Results: 137 patients who received the InS:PIRE intervention completed outcome measures at 12 months. In the usual care cohort, 115 patients completed the measures. The two cohorts had similar baseline demographics. After adjustment, there was a significant absolute increase in HRQoL in the intervention cohort in relation to the usual care cohort (0.12, 95% CI 0.04 to 0.20, 0.01). Patients in the InS:PIRE cohort also reported self-efficacy scores that were 7.7% higher (2.32 points higher, 95% CI 0.32 to 4.31, =0.02), fewer symptoms of depression (OR 0.38, 95% CI 0.19 to 0.76, p=0.01) and similar symptoms of anxiety (OR 0.58, 95% CI 0.30 to 1.13, =0.11). There was no significant difference in overall pain experience. Key facilitators for implementation were: integration with inpatient care, organisational engagement, flexibility to service inclusion; key barriers were: funding, staff availability and venue availability.

Conclusions: This multicentre evaluation of a health and social care programme designed for survivors of critical illness appears to show benefit at 12 months following hospital discharge.

Citing Articles

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[Post-Intensive Care Syndrome: functional impairments of critical illness survivors].

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Fleischmann-Struzek C, Joost F, Pletz M, Weiss B, Paul N, Wesley Ely E Crit Care. 2024; 28(1):283.

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