Enhanced Recovery after Intensive Care (ERIC): study protocol for a German stepped wedge cluster randomised controlled trial to evaluate the effectiveness of a critical care telehealth program on process quality and functional outcomes

Adrion, Christine; Weiß, Björn; Paul, Nicolas; Berger, Elke; Busse, Reinhard; Marschall, Ursula; Caumanns, Jörg; Rosseau, Simone; Mansmann, Ulrich; Spies, Claudia

doi:10.1136/bmjopen-2019-036096

Cited by 20 publications

(16 citation statements)

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“…Because the use of MV at a minimum of 3 days is an inclusion criterion enabling the selection of patients with severe critical illness, the results will be obtained from a representative population at risk of developing PICS. Its results could be then compared with those of ongoing trials assessing the benefit of telehealth [ 51 ], combined physical and cognitive training [ 52 ], or multidisciplinary personalized follow-up [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of a Postintensive Care Unit Multidisciplinary Follow-up on the Quality of Life (SUIVI-REA): Protocol for a Multicenter Randomized Controlled Trial

Friedman¹,

Grimaldi-Bensouda²,

Cariou³

et al. 2022

JMIR Res Protoc

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Background Critically ill patients are at risk of developing a postintensive care syndrome (PICS), which is characterized by physical, psychological, and cognitive impairments and which dramatically impacts the patient’s quality of life (QoL). No intervention has been shown to improve QoL. We hypothesized that a medical, psychological, and social follow-up would improve QoL by mitigating the PICS. Objective This multicenter, randomized controlled trial (SUIVI-REA) aims to compare a multidisciplinary follow-up with a standard postintensive care unit (ICU) follow-up. Methods Patients were randomized to the control or intervention arm. In the intervention arm, multidisciplinary follow-up involved medical, psychological, and social evaluation at ICU discharge and at 3, 6, and 12 months thereafter. In the placebo group, patients were seen only at 12 months by the multidisciplinary team. Baseline characteristics at ICU discharge were collected for all patients. The primary outcome was QoL at 1 year, assessed using the Euro Quality of Life-5 dimensions (EQ5D). Secondary outcomes were mortality, cognitive, psychological, and functional status; social and professional reintegration; and the rate of rehospitalization and outpatient consultations at 1 year. Results The study was funded by the Ministry of Health in June 2010. It was approved by the Ethics Committee on July 8, 2011. The first and last patient were randomized on December 20, 2012, and September 1, 2017, respectively. A total of 546 patients were enrolled across 11 ICUs. At present, data management is ongoing, and all parties involved in the trial remain blinded. Conclusions The SUVI-REA multicenter randomized controlled trial aims to assess whether a post-ICU multidisciplinary follow-up improves QoL at 1 year. Trial Registration Clinicaltrials.gov NCT01796509; https://clinicaltrials.gov/ct2/show/NCT01796509 International Registered Report Identifier (IRRID) DERR1-10.2196/30496

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Section: Discussionmentioning

confidence: 99%

Impact of a Postintensive Care Unit Multidisciplinary Follow-up on the Quality of Life (SUIVI-REA): Protocol for a Multicenter Randomized Controlled Trial

Friedman¹,

Grimaldi-Bensouda²,

Cariou³

et al. 2022

JMIR Res Protoc

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“…This article adheres to the Consolidated Standards of Reporting Trials (CONSORT) statement extended for stepped-wedge cluster randomised trials [ 15 ] and related guidelines [ 16 ]. Details of the study protocol with intervention details have been published elsewhere [ 17 ]. The study was prospectively registered with ClinicalTrials.gov (NCT03671447).…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of an intensive care telehealth programme to improve process quality (ERIC): a multicentre stepped wedge cluster randomised controlled trial

et al. 2023

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Purpose Supporting the provision of intensive care medicine through telehealth potentially improves process quality. This may improve patient recovery and long-term outcomes. We investigated the effectiveness of a multifaceted telemedical programme on the adherence to German quality indicators (QIs) in a regional network of intensive care units (ICUs) in Germany. Methods We conducted an investigator-initiated, large-scale, open-label, stepped-wedge cluster randomised controlled trial enrolling adult ICU patients with an expected ICU stay of ≥ 24 h. Twelve ICU clusters in Berlin and Brandenburg were randomly assigned to three sequence groups to transition from control (standard care) to the intervention condition (telemedicine). The quality improvement intervention consisted of daily telemedical rounds guided by eight German acute ICU care QIs and expert consultations. Co-primary effectiveness outcomes were patient-specific daily adherence (fulfilled yes/no) to QIs, assessed by a central end point adjudication committee. Analyses used mixed-effects logistic modelling adjusted for time. This study is completed and registered with ClinicalTrials.gov (NCT03671447). Results Between September 4, 2018, and March 31, 2020, 1463 patients (414 treated on control, 1049 on intervention condition) were enrolled at ten clusters, resulting in 14,783 evaluated days. Two randomised clusters recruited no patients (one withdrew informed consent; one dropped out). The intervention, as implemented, significantly increased QI performance for “sedation, analgesia and delirium” (adjusted odds ratio (99.375% confidence interval [CI]) 5.328, 3.395–8.358), “ventilation” (OR 2.248, 1.198–4.217), “weaning from ventilation” (OR 9.049, 2.707–30.247), “infection management” (OR 4.397, 1.482–13.037), “enteral nutrition” (OR 1.579, 1.032–2.416), “patient and family communication” (OR 6.787, 3.976–11.589), and "early mobilisation" (OR 3.161, 2.160–4.624). No evidence for a difference in adherence to “daily multi-professional and interdisciplinary clinical visits” between both conditions was found (OR 1.606, 0.780–3.309). Temporal trends related and unrelated to the intervention were detected. 149 patients died during their index ICU stay (45 treated on control, 104 on intervention condition). Conclusion A telemedical quality improvement program increased adherence to seven evidence-based German performance indicators in acute ICU care. These results need further confirmation in a broader setting of regional, non-academic community hospitals and other healthcare systems. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-022-06949-x.

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“…Su uso en la práctica clínica se ve limitado por la necesidad de un equipo especial y de formación (9). rendimiento físico serie corta de rendimiento físico: Se utiliza la escala SPPB (Batería Breve de Rendimiento Físico) evalúa el equilibrio, la marcha, la fuerza y la resistencia mediante un examen de la capacidad de una persona de mantenerse de pie con los pies juntos, uno al lado de otro, en semitándem y en tándem, el tiempo que se tarda en recorrer caminando 2.4 m y el tiempo que se tarda en levantarse de una silla y volver a sentarse cinco veces (59).…”

Section: Fuerza Muscularunclassified

Prevención de la sarcopenia en pacientes con enfermedad de Parkinson: Revisión descriptiva desde la medicina preventiva

2021

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Resumen: La enfermedad de Parkinson ocupa el segundo lugar de las enfermedades neurodegenerativas más comunes en el mundo. La sarcopenia se caracteriza por dinapenia y en los adultos mayores con diagnóstico de enfermedad de Parkinson acelera su progresión. El objetivo de la presente revisión es describir el estado sarcopénico y la importancia de su prevención en los adultos mayores con enfermedad de Parkinson, así como ofrecer una revisión de las medidas de prevención primaria, secundaria y terciaria pertinentes para su abordaje. Si bien el deterioro y la gravedad de la enfermedad de Parkinson se relaciona directamente con el estado sarcopénico del paciente mediante el abordaje disciplinario, la medicina preventiva puede favorecer la calidad de vida de los pacientes mediante medidas de promoción, diagnóstico oportuno, tratamiento farmacológico y no farmacológico y limitación de la progresión de la sarcopenia.Abstract: Parkinson's disease ranks second among the most common neurodegenerative diseases in the world. Sarcopenia is characterized by dynapenia and in older adults diagnosed with Parkinson's disease accelerates its progression. The objective of the present review is to describe the sarcopenic state and the importance of its prevention in older adults with Parkinson's disease, as well as to offer a review of primary prevention measures, secondary and tertiary relevant to its approach. Although the deterioration and severity of Parkinson's disease is directly related to the sarcopenic state of the patient through the disciplinary approach, preventive medicine can favor the quality of life of patients through promotional measures, timely diagnosis, pharmacological treatment and not pharmacological and limiting the progression of sarcopenia.

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Enhanced Recovery after Intensive Care (ERIC): study protocol for a German stepped wedge cluster randomised controlled trial to evaluate the effectiveness of a critical care telehealth program on process quality and functional outcomes

Cited by 20 publications

References 61 publications

Impact of a Postintensive Care Unit Multidisciplinary Follow-up on the Quality of Life (SUIVI-REA): Protocol for a Multicenter Randomized Controlled Trial

Impact of a Postintensive Care Unit Multidisciplinary Follow-up on the Quality of Life (SUIVI-REA): Protocol for a Multicenter Randomized Controlled Trial

Effectiveness of an intensive care telehealth programme to improve process quality (ERIC): a multicentre stepped wedge cluster randomised controlled trial

Prevención de la sarcopenia en pacientes con enfermedad de Parkinson: Revisión descriptiva desde la medicina preventiva

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