A Pragmatic Randomised, Controlled Trial of Intensive Care follow up programmes in improving Longer-term outcomes from critical illness. The PRACTICAL study

<p>Abstract</p> <p>Background</p> <p>A number of intensive care (ICU) patients experience significant problems with physical, psychological, and social functioning for some time after discharge from ICU. These problems have implications not just for patients, but impose...

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Main Authors: Ramsey Craig, Hernendez Rodolfo, Wilson Edward, Wildsmith J Anthony, Johnston Marie, Rattray Janice, Cuthbertson Brian H, Hull Alastair M, Norrie John, Campbell Marion
Format: Article
Language:English
Published: BMC 2007-07-01
Series:BMC Health Services Research
Online Access:http://www.biomedcentral.com/1472-6963/7/116
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author Ramsey Craig
Hernendez Rodolfo
Wilson Edward
Wildsmith J Anthony
Johnston Marie
Rattray Janice
Cuthbertson Brian H
Hull Alastair M
Norrie John
Campbell Marion
author_facet Ramsey Craig
Hernendez Rodolfo
Wilson Edward
Wildsmith J Anthony
Johnston Marie
Rattray Janice
Cuthbertson Brian H
Hull Alastair M
Norrie John
Campbell Marion
author_sort Ramsey Craig
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>A number of intensive care (ICU) patients experience significant problems with physical, psychological, and social functioning for some time after discharge from ICU. These problems have implications not just for patients, but impose a continuing financial burden for the National Health Service. To support recovery, a number of hospitals across the UK have developed Intensive Care follow-up clinics. However, there is a lack of evidence base to support these, and this study aims to test the hypothesis that intensive care follow up programmes are effective and cost-effective at improving physical and psychological quality of life in the year after intensive care discharge.</p> <p>Methods/Design</p> <p>This is a multi-centre, pragmatic, randomised controlled trial. Patients (n = 270) will be recruited prior to hospital discharge from three intensive care units in the UK, and randomised to one of two groups. The control group will receive standard in-hospital follow-up and the intervention group will participate in an ICU follow-up programme with clinic appointments 2–3 and 9 months after ICU discharge.</p> <p>The primary outcome measure is Health-related Quality of Life (HRQoL) 12 months after ICU discharge as measured by the Short Form-36. Secondary measures include: HRQoL at six months; Quality-adjusted life years using EQ-5D; posttraumatic psychopathology as measured by Davidson Trauma Scale; and anxiety and depression using the Hospital Anxiety and Depression Scale at both six and twelve months after ICU discharge. Contacts with health services in the twelve months after ICU discharge will be measured as part of the economic analysis.</p> <p>Discussion</p> <p>The provision of intensive care follow-up clinics within the UK has developed in an ad hoc manner, is inconsistent in both the number of hospitals offering such a service or in the type of service offered. This study provides the opportunity to evaluate such services both in terms of patient benefit and cost-effectiveness. The results of this study therefore will inform clinical practice and policy with regard to the appropriate development of such services aimed at improving outcomes after intensive care.</p> <p>Trial Registration</p> <p>ISRCTN24294750.</p>
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spelling doaj.art-b61ad0cd356e49a28b676020eeea51512022-12-22T02:47:26ZengBMCBMC Health Services Research1472-69632007-07-017111610.1186/1472-6963-7-116A Pragmatic Randomised, Controlled Trial of Intensive Care follow up programmes in improving Longer-term outcomes from critical illness. The PRACTICAL studyRamsey CraigHernendez RodolfoWilson EdwardWildsmith J AnthonyJohnston MarieRattray JaniceCuthbertson Brian HHull Alastair MNorrie JohnCampbell Marion<p>Abstract</p> <p>Background</p> <p>A number of intensive care (ICU) patients experience significant problems with physical, psychological, and social functioning for some time after discharge from ICU. These problems have implications not just for patients, but impose a continuing financial burden for the National Health Service. To support recovery, a number of hospitals across the UK have developed Intensive Care follow-up clinics. However, there is a lack of evidence base to support these, and this study aims to test the hypothesis that intensive care follow up programmes are effective and cost-effective at improving physical and psychological quality of life in the year after intensive care discharge.</p> <p>Methods/Design</p> <p>This is a multi-centre, pragmatic, randomised controlled trial. Patients (n = 270) will be recruited prior to hospital discharge from three intensive care units in the UK, and randomised to one of two groups. The control group will receive standard in-hospital follow-up and the intervention group will participate in an ICU follow-up programme with clinic appointments 2–3 and 9 months after ICU discharge.</p> <p>The primary outcome measure is Health-related Quality of Life (HRQoL) 12 months after ICU discharge as measured by the Short Form-36. Secondary measures include: HRQoL at six months; Quality-adjusted life years using EQ-5D; posttraumatic psychopathology as measured by Davidson Trauma Scale; and anxiety and depression using the Hospital Anxiety and Depression Scale at both six and twelve months after ICU discharge. Contacts with health services in the twelve months after ICU discharge will be measured as part of the economic analysis.</p> <p>Discussion</p> <p>The provision of intensive care follow-up clinics within the UK has developed in an ad hoc manner, is inconsistent in both the number of hospitals offering such a service or in the type of service offered. This study provides the opportunity to evaluate such services both in terms of patient benefit and cost-effectiveness. The results of this study therefore will inform clinical practice and policy with regard to the appropriate development of such services aimed at improving outcomes after intensive care.</p> <p>Trial Registration</p> <p>ISRCTN24294750.</p>http://www.biomedcentral.com/1472-6963/7/116
spellingShingle Ramsey Craig
Hernendez Rodolfo
Wilson Edward
Wildsmith J Anthony
Johnston Marie
Rattray Janice
Cuthbertson Brian H
Hull Alastair M
Norrie John
Campbell Marion
A Pragmatic Randomised, Controlled Trial of Intensive Care follow up programmes in improving Longer-term outcomes from critical illness. The PRACTICAL study
BMC Health Services Research
title A Pragmatic Randomised, Controlled Trial of Intensive Care follow up programmes in improving Longer-term outcomes from critical illness. The PRACTICAL study
title_full A Pragmatic Randomised, Controlled Trial of Intensive Care follow up programmes in improving Longer-term outcomes from critical illness. The PRACTICAL study
title_fullStr A Pragmatic Randomised, Controlled Trial of Intensive Care follow up programmes in improving Longer-term outcomes from critical illness. The PRACTICAL study
title_full_unstemmed A Pragmatic Randomised, Controlled Trial of Intensive Care follow up programmes in improving Longer-term outcomes from critical illness. The PRACTICAL study
title_short A Pragmatic Randomised, Controlled Trial of Intensive Care follow up programmes in improving Longer-term outcomes from critical illness. The PRACTICAL study
title_sort pragmatic randomised controlled trial of intensive care follow up programmes in improving longer term outcomes from critical illness the practical study
url http://www.biomedcentral.com/1472-6963/7/116
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