Evaluation of a heath and social care programme to improve outcome following critical illness: a multicentre study

Henderson, P. et al. (2022) Evaluation of a heath and social care programme to improve outcome following critical illness: a multicentre study. Thorax, (doi: 10.1136/thoraxjnl-2021-218428) (Early Online Publication)

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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, p=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, p=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, p=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.

Item Type:Articles
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Mactavish, Mrs Pamela and Sim, Malcolm and Henderson, Dr Philip and Quasim, Professor Tara and Sundaram, Dr Radha and McPeake, Dr Jo and Shaw, Dr Martin and Daniel, Malcolm
Authors: Henderson, P., Quasim, T., Shaw, M., Mactavish, P., Devine, H., Daniel, M., Nicolson, F., O’Brien, P., Weir, A., Strachan, L., Senior, L., Lucie, P., Bollan, L., Duffty, J., Hogg, L., Ross, C., Sim, M., Sundaram, R., Iwashyna, T. J., and McPeake, J.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
Journal Name:Thorax
Publisher:BMJ Publishing Group
ISSN:0040-6376
ISSN (Online):1468-3296
Published Online:21 March 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in Thorax 2022
Publisher Policy:Reproduced under a Creative Commons licence

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
173544Intensive Care Syndrome: Promoting Independence and Return to EmploymentTara QuasimThe Health Foundation (HEALFOU)Quasim, Dr TaraMed - Anaesthesia
307748Improving health and social care integration delivery in the acute care environmentJoanne McPeakeUniversity of Cambridge (HEI-CAMB)RG88620HW - MRC/CSO Social and Public Health Sciences Unit