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Intensive Care Medicine
Erschienen in:

30.01.2019 | Original

Tailored multicomponent program for discomfort reduction in critically ill patients may decrease post-traumatic stress disorder in general ICU survivors at 1 year

verfasst von: Pierre Kalfon, Marine Alessandrini, Mohamed Boucekine, Stéphanie Renoult, Marie-Agnès Geantot, Stéphanie Deparis-Dusautois, Audrey Berric, Olivier Collange, Bernard Floccard, Olivier Mimoz, Amour Julien, René Robert, Juliette Audibert, Anne Renault, Arnaud Follin, Didier Thevenin, Nathalie Revel, Marion Venot, René-Gilles Patrigeon, Thomas Signouret, Mélanie Fromentin, Tarek Sharshar, Coralie Vigne, Julien Pottecher, Quentin Levrat, Achille Sossou, Maïté Garrouste-Orgeas, Jean-Pierre Quenot, Claire Boulle, Elie Azoulay, Karine Baumstarck, Pascal Auquier, the IPREA-AQVAR Study Group

Erschienen in: Intensive Care Medicine | Ausgabe 2/2019

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Abstract

Purpose

Reducing discomfort in the intensive care unit (ICU) should have a positive effect on long-term outcomes. This study assessed whether a tailored multicomponent program for discomfort reduction was effective in reducing post-traumatic stress disorder (PTSD) symptoms at 1 year in general ICU survivors.

Methods

This study is a prospective observational comparative effectiveness cohort study involving 30 ICUs. It was an extension of the IPREA3 study, a cluster-randomized controlled trial designed to assess the efficacy of a tailored multicomponent program to reduce discomfort in critically ill patients. The program included assessment of ICU-related self-perceived discomforts, immediate and monthly feedback to the healthcare team, and site-specific tailored interventions. The exposure was the implementation of this program. The eligible patients were exposed versus unexposed general adult ICU survivors. The prevalence of substantial PTSD symptoms at 1 year was assessed based on the Impact of Event Scale–Revised (IES-R).

Results

Of the 1537 ICU survivors included in the study, 475 unexposed patients and 344 exposed patients had follow-up data at 1 year: 57 (12.0%) and 21 (6.1%) presented with PTSD at 1 year, respectively (p = 0.004). Considering the clustering and after adjusting for age, gender, McCabe classification, and ICU-related self-perceived overall discomfort score, exposed patients were significantly less likely than unexposed patients to have substantial PTSD symptoms at 1 year (p = 0.015).

Conclusions

Implementation of a tailored multicomponent program in the ICU that has proved to be effective for reducing self-perceived discomfort in general adult ICU survivors also reduced the prevalence of substantial PTSD symptoms at 1 year.

Trial registration

ClinicalTrials.gov identifier NCT02762409.
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Metadaten
Titel
Tailored multicomponent program for discomfort reduction in critically ill patients may decrease post-traumatic stress disorder in general ICU survivors at 1 year
verfasst von
Pierre Kalfon
Marine Alessandrini
Mohamed Boucekine
Stéphanie Renoult
Marie-Agnès Geantot
Stéphanie Deparis-Dusautois
Audrey Berric
Olivier Collange
Bernard Floccard
Olivier Mimoz
Amour Julien
René Robert
Juliette Audibert
Anne Renault
Arnaud Follin
Didier Thevenin
Nathalie Revel
Marion Venot
René-Gilles Patrigeon
Thomas Signouret
Mélanie Fromentin
Tarek Sharshar
Coralie Vigne
Julien Pottecher
Quentin Levrat
Achille Sossou
Maïté Garrouste-Orgeas
Jean-Pierre Quenot
Claire Boulle
Elie Azoulay
Karine Baumstarck
Pascal Auquier
the IPREA-AQVAR Study Group
Publikationsdatum
30.01.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Intensive Care Medicine / Ausgabe 2/2019
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-018-05511-y

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