Improving Medical and Psychological Outcomes After Discharge - Feasibility Study for a Pragmatic, Mixed-methods, Open-label Randomized Controlled Trial Examining the Effectiveness of a Follow-up Clinic for ICU Survivors and Caregivers
\ 80% of ICU survivors experience profound long-term cognitive, physical, and psychiatric impairments known as post-intensive care syndrome (PICS). Caregivers additionally experience similar detrimental psychosocial effects following discharge. Despite this knowledge, follow-up care is almost non-existent. ICU follow-up clinics may mitigate these long-term impacts, but lack evaluation of their effectiveness. This trial will evaluate the effectiveness of ICU follow-up clinics vs. standard-of-care in improving qualitative/clinical outcomes of ICU survivors and caregivers, with those receiving follow-up care hypothesized to have improved outcomes.
• Adult patients (age greater than or equal to 18 years)
• Life expectancy greater than or equal to 6 months as determined by the attending physician
• High risk for long-term functional sequelae following ICU discharge, defined as ICU stay greater than or equal to 4 days, or involving at least one of:
‣ mechanical ventilation (any, i.e., invasive or non-invasive)
⁃ tracheostomy
⁃ delirium (defined as Confusion Assessment Method (CAM) positive or documented history of delirium in the patient's medical record by the clinical care team at some point during their ICU admission)
⁃ lack of access to a primary care physician for clinical follow-up
⁃ access to email or mail to complete follow-up questionnaires
⁃ presence of an informal caregiver
• Informal caregiver (e.g., spouse, offspring) for ICU survivor as defined above
• Adult (age greater than or equal to 18 years)