A Pragmatic Randomised, Controlled Trial Of Intensive Care Follow Up Clinics In Improving Longer-Term Outcomes From Critical Illness

The PRaCTICaL Study

BH Cuthbertson, J Rattray, M Gager, S Roughton, A Smith, MK Campbell, A Hull, J Norrie, D Jenkinson, R Hernández, M Johnston, E Wilson, C Waldmann, PRaCTICaL Study Group

Research output: Book/ReportCommissioned Report

Abstract

Abstract
BACKGROUND: 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.

METHODS/DESIGN: 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. 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.

DISCUSSION: 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.

TRIAL REGISTRATION: ISRCTN24294750.

Original languageEnglish
Place of PublicationEdinburgh, United Kingdom
PublisherChief Scientist Office
Number of pages6
Publication statusPublished - May 2009

Publication series

NameFocus on Research
PublisherChief Scientist Office
No.CZH/4/351

Fingerprint

Critical Care
Critical Illness
Randomized Controlled Trials
Quality of Life
Cost-Benefit Analysis
Anxiety
Depression
Psychology
Quality-Adjusted Life Years
National Health Programs
Psychopathology
Health Services
Intensive Care Units
Appointments and Schedules
Economics
Outcome Assessment (Health Care)
Costs and Cost Analysis
Control Groups
Wounds and Injuries

Cite this

Cuthbertson, BH., Rattray, J., Gager, M., Roughton, S., Smith, A., Campbell, MK., ... PRaCTICaL Study Group (2009). A Pragmatic Randomised, Controlled Trial Of Intensive Care Follow Up Clinics In Improving Longer-Term Outcomes From Critical Illness: The PRaCTICaL Study. (Focus on Research; No. CZH/4/351). Edinburgh, United Kingdom: Chief Scientist Office.

A Pragmatic Randomised, Controlled Trial Of Intensive Care Follow Up Clinics In Improving Longer-Term Outcomes From Critical Illness : The PRaCTICaL Study. / Cuthbertson, BH; Rattray, J; Gager, M; Roughton, S; Smith, A; Campbell, MK; Hull, A; Norrie, J; Jenkinson, D; Hernández, R; Johnston, M; Wilson, E; Waldmann, C; PRaCTICaL Study Group.

Edinburgh, United Kingdom : Chief Scientist Office, 2009. 6 p. (Focus on Research; No. CZH/4/351).

Research output: Book/ReportCommissioned Report

Cuthbertson, BH, Rattray, J, Gager, M, Roughton, S, Smith, A, Campbell, MK, Hull, A, Norrie, J, Jenkinson, D, Hernández, R, Johnston, M, Wilson, E, Waldmann, C & PRaCTICaL Study Group 2009, A Pragmatic Randomised, Controlled Trial Of Intensive Care Follow Up Clinics In Improving Longer-Term Outcomes From Critical Illness: The PRaCTICaL Study. Focus on Research, no. CZH/4/351, Chief Scientist Office, Edinburgh, United Kingdom.
Cuthbertson BH, Rattray J, Gager M, Roughton S, Smith A, Campbell MK et al. A Pragmatic Randomised, Controlled Trial Of Intensive Care Follow Up Clinics In Improving Longer-Term Outcomes From Critical Illness: The PRaCTICaL Study. Edinburgh, United Kingdom: Chief Scientist Office, 2009. 6 p. (Focus on Research; CZH/4/351).
Cuthbertson, BH ; Rattray, J ; Gager, M ; Roughton, S ; Smith, A ; Campbell, MK ; Hull, A ; Norrie, J ; Jenkinson, D ; Hernández, R ; Johnston, M ; Wilson, E ; Waldmann, C ; PRaCTICaL Study Group. / A Pragmatic Randomised, Controlled Trial Of Intensive Care Follow Up Clinics In Improving Longer-Term Outcomes From Critical Illness : The PRaCTICaL Study. Edinburgh, United Kingdom : Chief Scientist Office, 2009. 6 p. (Focus on Research; CZH/4/351).
@book{71c1cfe893374821b2a682594b9d3470,
title = "A Pragmatic Randomised, Controlled Trial Of Intensive Care Follow Up Clinics In Improving Longer-Term Outcomes From Critical Illness: The PRaCTICaL Study",
abstract = "Abstract BACKGROUND: 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. METHODS/DESIGN: 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. 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. DISCUSSION: 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. TRIAL REGISTRATION: ISRCTN24294750.",
author = "BH Cuthbertson and J Rattray and M Gager and S Roughton and A Smith and MK Campbell and A Hull and J Norrie and D Jenkinson and R Hern{\'a}ndez and M Johnston and E Wilson and C Waldmann and {PRaCTICaL Study Group}",
note = "Report commissioned by the Scottish Government Health Directorate Chief Scientist Office",
year = "2009",
month = "5",
language = "English",
series = "Focus on Research",
publisher = "Chief Scientist Office",
number = "CZH/4/351",

}

TY - BOOK

T1 - A Pragmatic Randomised, Controlled Trial Of Intensive Care Follow Up Clinics In Improving Longer-Term Outcomes From Critical Illness

T2 - The PRaCTICaL Study

AU - Cuthbertson, BH

AU - Rattray, J

AU - Gager, M

AU - Roughton, S

AU - Smith, A

AU - Campbell, MK

AU - Hull, A

AU - Norrie, J

AU - Jenkinson, D

AU - Hernández, R

AU - Johnston, M

AU - Wilson, E

AU - Waldmann, C

AU - PRaCTICaL Study Group

N1 - Report commissioned by the Scottish Government Health Directorate Chief Scientist Office

PY - 2009/5

Y1 - 2009/5

N2 - Abstract BACKGROUND: 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. METHODS/DESIGN: 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. 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. DISCUSSION: 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. TRIAL REGISTRATION: ISRCTN24294750.

AB - Abstract BACKGROUND: 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. METHODS/DESIGN: 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. 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. DISCUSSION: 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. TRIAL REGISTRATION: ISRCTN24294750.

M3 - Commissioned Report

T3 - Focus on Research

BT - A Pragmatic Randomised, Controlled Trial Of Intensive Care Follow Up Clinics In Improving Longer-Term Outcomes From Critical Illness

PB - Chief Scientist Office

CY - Edinburgh, United Kingdom

ER -