Evaluation of a health and social care programme to improve outcomes following critical illness : a multicentre study
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
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.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:78 |
|---|---|
| Enthalten in: |
Thorax - 78(2023), 2 vom: 21. Feb., Seite 160-168 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Henderson, Philip [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
ARDS |
|---|
| Anmerkungen: |
Date Completed 16.01.2023 Date Revised 03.11.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1136/thoraxjnl-2021-218428 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM338449183 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM338449183 | ||
| 003 | DE-627 | ||
| 005 | 20231226000712.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1136/thoraxjnl-2021-218428 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1128.xml |
| 035 | |a (DE-627)NLM338449183 | ||
| 035 | |a (NLM)35314485 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Henderson, Philip |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Evaluation of a health and social care programme to improve outcomes following critical illness |b a multicentre study |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 16.01.2023 | ||
| 500 | |a Date Revised 03.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a RATIONALE: At present, clinicians aiming to support patients through the challenges after critical care have limited evidence to base interventions | ||
| 520 | |a OBJECTIVES: Evaluate a multicentre integrated health and social care intervention for critical care survivors. A process evaluation assessed factors influencing the programme implementation | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a ARDS | |
| 650 | 4 | |a critical care | |
| 650 | 4 | |a pulmonary rehabilitation | |
| 700 | 1 | |a Quasim, Tara |e verfasserin |4 aut | |
| 700 | 1 | |a Shaw, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a MacTavish, Pamela |e verfasserin |4 aut | |
| 700 | 1 | |a Devine, Helen |e verfasserin |4 aut | |
| 700 | 1 | |a Daniel, Malcolm |e verfasserin |4 aut | |
| 700 | 1 | |a Nicolson, Fiona |e verfasserin |4 aut | |
| 700 | 1 | |a O'Brien, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Weir, Ashley |e verfasserin |4 aut | |
| 700 | 1 | |a Strachan, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Senior, Lorraine |e verfasserin |4 aut | |
| 700 | 1 | |a Lucie, Phil |e verfasserin |4 aut | |
| 700 | 1 | |a Bollan, Lynn |e verfasserin |4 aut | |
| 700 | 1 | |a Duffty, Jane |e verfasserin |4 aut | |
| 700 | 1 | |a Hogg, Lucy |e verfasserin |4 aut | |
| 700 | 1 | |a Ross, Colette |e verfasserin |4 aut | |
| 700 | 1 | |a Sim, Malcolm |e verfasserin |4 aut | |
| 700 | 1 | |a Sundaram, Radha |e verfasserin |4 aut | |
| 700 | 1 | |a Iwashyna, Theodore J |e verfasserin |4 aut | |
| 700 | 1 | |a McPeake, Joanne |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Thorax |d 1946 |g 78(2023), 2 vom: 21. Feb., Seite 160-168 |w (DE-627)NLM00010387X |x 1468-3296 |7 nnns |
| 773 | 1 | 8 | |g volume:78 |g year:2023 |g number:2 |g day:21 |g month:02 |g pages:160-168 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1136/thoraxjnl-2021-218428 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 78 |j 2023 |e 2 |b 21 |c 02 |h 160-168 | ||