Henderson, P. et al. (2023) Evaluation of a heath and social care programme to improve outcome following critical illness: a multicentre study. Thorax, 78(2), pp. 160-168. (doi: 10.1136/thoraxjnl-2021-218428) (PMID:35314485) (PMCID:PMC9872253)
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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: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Sundaram, Dr Radha and Henderson, Dr Philip and Daniel, Malcolm and Mactavish, Mrs Pamela and Quasim, Professor Tara and Sim, Malcolm and Shaw, Dr Martin and McPeake, Dr Jo |
| 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 © Author(s) (or their employer(s)) 2023 |
| First Published: | First published in Thorax 78(2):160-168 |
| Publisher Policy: | Reproduced under a Creative Commons licence |
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