The challenge of ICU survivorship; a novel approach to recovery

Introduction: The implications of an ICU experience on individuals, families and health care services is significant and has been widely acknowledged over the last two decades. These complications include anxiety and depression, Post Traumatic Stress Disorder and reduced quality of life. Despite years of exploration of interventions including ICU follow up clinics and ICU diaries, an established evidence-based process, which supports survivors, remains elusive within Australia. Survivors are notoriously difficult to engage in research, deeming innovation to encourage them to participate is suggested.

Objective: The aim of this study is to evaluate the impact of a web-based intensive care recovery program on the mental well-being of intensive care survivors and to determine if this is a cost-effective approach.

Methods: One hundred and sixty-two survivors will be randomised to the intervention group and receive access to the web-based recovery program “ICUTogether”; the control group will receive usual care. Mental well-being will be measured using the Hospital Anxiety and Depression Scale, The Impact of Events Scale-Revised and the 5-level 5-dimension EuroQoL at three time points. Family support will be measured using the Multidimensional Scale of Perceived Social Support. Analysis will be conducted on an intention-to-treat basis using regression modelling. Covariates will include baseline outcome measures, study allocation (intervention or control), age, gender, length of ICU stay, APACHE III score, level of family support, and hospital readmissions. Participants’ evaluation of the mobile website will be sought at 12 months. A cost utility analysis conducted at 12 months from a societal perspective will consider costs incurred by individuals as well as health care providers.

Results: Preliminary qualitative data will be presented. The challenges of recruitment will also be discussed.

Conclusion: This is a very challenging area of work for the intensive care community and this presentation aims to share an approach which may have wider application.