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Henderson, Philip; Quasim, Tara; Shaw, Martin; MacTavish, Pamela; Devine, Helen; Daniel, Malcolm; Nicolson, Fiona; O’Brien, Peter; Weir, Ashley; Strachan, Laura; Senior, Lorraine; Lucie, Phil; Bollan, Lynn; Duffty, Jane; Hogg, Lucy; Ross, Colette; Sim, Malcolm; Sundaram, Radha; Iwashyna, Theodore J; McPeake, Joanne

Evaluation of a health and social care programme to improve outcomes following critical illness: a multicentre study

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  • Media type: E-Article
  • Title: Evaluation of a health and social care programme to improve outcomes following critical illness: a multicentre study
  • Contributor: Henderson, Philip; Quasim, Tara; Shaw, Martin; MacTavish, Pamela; Devine, Helen; Daniel, Malcolm; Nicolson, Fiona; O’Brien, Peter; Weir, Ashley; Strachan, Laura; Senior, Lorraine; Lucie, Phil; Bollan, Lynn; Duffty, Jane; Hogg, Lucy; Ross, Colette; Sim, Malcolm; Sundaram, Radha; Iwashyna, Theodore J; McPeake, Joanne
  • Published: BMJ, 2023
  • Published in: Thorax, 78 (2023) 2, Seite 160-168
  • Language: English
  • DOI: 10.1136/thoraxjnl-2021-218428
  • ISSN: 0040-6376; 1468-3296
  • Keywords: Pulmonary and Respiratory Medicine
  • Origination:
  • Footnote:
  • Description: <jats:sec><jats:title>Rationale</jats:title><jats:p>At present, clinicians aiming to support patients through the challenges after critical care have limited evidence to base interventions.</jats:p></jats:sec><jats:sec><jats:title>Objectives</jats:title><jats:p>Evaluate a multicentre integrated health and social care intervention for critical care survivors. A process evaluation assessed factors influencing the programme implementation.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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,<jats:italic>p=</jats:italic>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,<jats:italic>p</jats:italic>=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,<jats:italic>p</jats:italic>=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.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>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.</jats:p></jats:sec>