Clinical trial NCT02784574: Post ICU Follow up: A Questionnaire Survey of Aftercare in Denmark
Official title: Follow-up After Intensive Care Treatment: a Questionnaire Survey of Intensive Care Aftercare in Denmark.
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Critical Illness
Intensive Care Unit Syndrome
Keywords: Rehabilitation
Aftercare
Lead sponsor: Zealand University Hospital
Sponsor class: OTHER
First posted: 2016-05-27
Enrollment: 31
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: All Intensive Care Units in Denmark treating adult patients.

Brief summary: This study aims to investigate current aftercare activities in Denmark after intensive care unit (ICU) treatment. The hypothesis is that a large number of hospitals offer aftercare, and these interventions are heterogenic and differ between hospitals and regions.

This study is an electronic questionnaire survey that aim to describe and map Danish aftercare activities, and future development plans in this field.

Detailed description: Annually, more than 30,000 patients are admitted for treatment at Danish intensive care units (ICUs). These critically ill patients are some of the most vulnerable in the health care system.

For years, focus has primarily been on treatment and survival of this patient group. As treatment effectiveness has gradually increased, the overall survival rate is now above 80%. Consequently, the period following ICU discharge has gained increasing focus and follow up interventions in the period after ICU treatment have become more common. These different follow up interventions has given name to the concept of 'aftercare'. Aftercare activities includes both early rehabilitation initiated during the continued hospital admission and also the following rehabilitation after hospital discharge.

Complications after intensive care treatment are numerous, including both physical, cognitive and psychological impairments, e.g. depression, muscle weakness, anxiety and social isolation. Together these symptoms are defined as post intensive care syndrome (PICS).

While it is clear that a need for aftercare exists, the optimal evidence based activities remains to be determined. The current follow-up activities are established as local initiatives and the methods vary greatly. Examples of present aftercare interventions include use of diaries, follow-up consultations, revisiting the ICU and assessment of quality of life.

A recent systematic review examined these different rehabilitation efforts, without finding significant effects of the present interventions, although usage of ICU-diaries had a minor preventive effect on post-traumatic stress syndrome (PTSD). A Danish meta-analysis from 2015 on follow-up consultations showed similar results.

Aftercare is a rapidly developing area and it is necessary to further investigate this important topic. Therefore, the investigators want to describe the current level of aftercare with a new mapping of activities in all Danish ICUs. Hereby, the investigators hope to create a better and up-to-date foundation for further development within Danish aftercare. Furthermore, the investigators wish to research on the clinician-experienced (the participants) attitude towards and limitations for aftercare activities, in order to discuss directions for future development.

Eligibility criteria: Inclusion Criteria:

* All Intensive Care Units in Denmark treating adult patients.

Exclusion Criteria:

Intensive care units with a specialty field within these four groups:

* Neurology and neurosurgery
* Cardiothoracic surgery
* Pediatrics or neonatology (PICU/NICU)
* Postoperative care units

Primary outcomes:
measure: Incidence of ICUs offering early aftercare to patients after discharge from ICU
timeFrame: From May 15th to September 31st 2016
measure: Incidence of ICUs offering late aftercare to patients after discharge from hospital
timeFrame: From May 15th to September 31st 2016
Secondary outcomes:
measure: Size of hospital (number of beds)
timeFrame: From May 15th to September 31st 2016
measure: Size of ICU (number of beds)
timeFrame: From May 15th to September 31st 2016
measure: Early aftercare: Use of protocol or checklist at patient visit
timeFrame: From May 15th to September 31st 2016
measure: Late aftercare: Use of protocol or checklist at patient visit
timeFrame: From May 15th to September 31st 2016
measure: Early aftercare: Selection of patients offered aftercare
timeFrame: From May 15th to September 31st 2016
measure: Late aftercare: Selection of patients offered aftercare
timeFrame: From May 15th to September 31st 2016
measure: Early aftercare: Time from ICU-discharge to first contact
timeFrame: From May 15th to September 31st 2016
measure: Late aftercare: Time from hospital discharge to first contact
timeFrame: From May 15th to September 31st 2016
measure: Early aftercare: Aftercare team members
timeFrame: From May 15th to September 31st 2016
measure: Early aftercare: Consumption of time
timeFrame: From May 15th to September 31st 2016
measure: Late aftercare: Aftercare team members
timeFrame: From May 15th to September 31st 2016
measure: Late aftercare: Consumption of time
timeFrame: From May 15th to September 31st 2016
measure: Early aftercare: Type of aftercare interventions during general ward stay
timeFrame: From May 15th to September 31st 2016
measure: Late aftercare: Type of aftercare interventions after hospital discharge
timeFrame: From May 15th to September 31st 2016
measure: Early aftercare: Type of screening tools or other methods used for patient assessment
timeFrame: From May 15th to September 31st 2016
measure: Late aftercare: Type of screening tools or other methods used for patient assessment
timeFrame: From May 15th to September 31st 2016
measure: Late aftercare: Contact method
timeFrame: From May 15th to September 31st 2016
measure: Late aftercare: Participation of family members
timeFrame: From May 15th to September 31st 2016
measure: Classifications of reasons for not having an aftercare programme at ICUs without an aftercare programme
timeFrame: From May 15th to September 31st 2016
measure: The responsible party for the financing of aftercare
timeFrame: From May 15th to September 31st 2016
measure: The respondent's own assessment of how aftercare will be prioritized at their ICU in one year.
timeFrame: From May 15th to September 31st 2016
measure: Should aftercare be offered?
timeFrame: From May 15th to September 31st 2016
Other outcomes:
Locations:
city: Køge
country: Denmark
facility: Zealand University Hospital
Study officials:
affiliation: Køge Hospital
name: Cilia KW Kjer, Bach.med
role: PRINCIPAL_INVESTIGATOR
References:
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