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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT04317144
Other study ID # WIVA001
Secondary ID
Status Active, not recruiting
Phase N/A
First received
Last updated
Start date January 7, 2019
Est. completion date October 7, 2025

Study information

Verified date May 2024
Source Uppsala University
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This study evaluates if a web-based 1-year programme is a useful method for follow-up intensive care survivors with short ICU-stay. Half of the participants are randomized into receiving the web-based follow-up while the other half will receive no follow-up.


Description:

It is not uncommon for Intensive care survivors to have persisting, psychiatric, cognitive and physical impairments long time after the critical illness occurred. Today, nurse-led follow-up is used but the main focus is on patients with a ICU-stay for at least three days. This study evaluates ICU-survivors with a maximum ICU-stay for 72 hours. Participants are randomized to the web-based one year follow-up programme and no follow-up. Both group receive questionnaire 2, 6 and 12 month after the end of their intensive care stay. The web-based follow-up programme includes, short lectures that describes the intensive care e.g. hallucinations, memory loss and delirium. The programme also include short films that shows the medical equipment and how and why it´s used. Regular contact with ICU-nurse to discuss any upcoming problems.


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 330
Est. completion date October 7, 2025
Est. primary completion date October 1, 2025
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - =18 years of age. - Treated at the ICU under the time of the study. - Have a Bank-id (which is needed to log in to the website.) Exclusion Criteria: - Institutionalized due to severe cognitive deficit. - Does not communicate in the Swedish language. - Patient is moved from other ICU to ICU where study is being held. - Patient is sent to another ICU from ICU where study is being held. - No home address. - Patient decline to participate in study. - Patient is receiving psychiatric specialist care post-icu e.g. high suicide risk. - Patient is receiving ICU-treatment due to violence and is under on-going police-investigation. - Palliative care. - Patient receiving in-hospital care for more than 4 weeks in a row (except patient who is cared for in physical rehab-clinic at the hospital).

Study Design


Related Conditions & MeSH terms

  • Post Intensive Care Unit Syndrome

Intervention

Behavioral:
Web-based follow-up programme.
Participants who are randomized to the intervention-group will have access to web-based follow-up for one year. The programme includes short films of equipment used in intensive care e.g. ventilator, suction-device. Continous renal replacement therapy , central vein catheter among other things. About 15 short films with icu-staff talking and show how the equipment works and alarm sounds. The intervention also includes lectures about how the ICU works and what problems a critically ill patient can suffer from post-icu. There is a built-in conversation tool in the programme that can be used both by the participant and the staff who works with the follow-up programme. Questionnaires is sent out 2,6 and 12 month post-icu. The questions include PTSD, Depression, QoL and physical activity. At the end of the study, participants are sent a questionnaire asking for their experience using the web-based follow up programme.
No follow-up
Participants randomized to "no follow-up" receive e-questionnaires 2, 6 and 12 months post-ICU care. The questions are the same as in web-based follow-up intervention group and include PTSD, Depression, QoL and physical activity.

Locations

Country Name City State
Sweden Uppsala University hospital Uppsala

Sponsors (1)

Lead Sponsor Collaborator
Uppsala University

Country where clinical trial is conducted

Sweden, 

References & Publications (28)

Agard AS, Egerod I, Tonnesen E, Lomborg K. Struggling for independence: a grounded theory study on convalescence of ICU survivors 12 months post ICU discharge. Intensive Crit Care Nurs. 2012 Apr;28(2):105-13. doi: 10.1016/j.iccn.2012.01.008. Epub 2012 Feb 25. — View Citation

Åkerman E, Fridh I, Orwelius L, Ringdal M, Shandl A. Nationella rekommendationer för uppföljning av patienter efter intensivvård. Riksföreningen Anestesi och intensivvård; 130617.

Ali NA, O'Brien JM Jr, Hoffmann SP, Phillips G, Garland A, Finley JC, Almoosa K, Hejal R, Wolf KM, Lemeshow S, Connors AF Jr, Marsh CB; Midwest Critical Care Consortium. Acquired weakness, handgrip strength, and mortality in critically ill patients. Am J Respir Crit Care Med. 2008 Aug 1;178(3):261-8. doi: 10.1164/rccm.200712-1829OC. Epub 2008 May 29. — View Citation

Axelsson E, Lindsater E, Ljotsson B, Andersson E, Hedman-Lagerlof E. The 12-item Self-Report World Health Organization Disability Assessment Schedule (WHODAS) 2.0 Administered Via the Internet to Individuals With Anxiety and Stress Disorders: A Psychometric Investigation Based on Data From Two Clinical Trials. JMIR Ment Health. 2017 Dec 8;4(4):e58. doi: 10.2196/mental.7497. — View Citation

Carlozzi NE, Kratz AL, Downing NR, Goodnight S, Miner JA, Migliore N, Paulsen JS. Validity of the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in individuals with Huntington disease (HD). Qual Life Res. 2015 Aug;24(8):1963-71. doi: 10.1007/s11136-015-0930-x. Epub 2015 Jan 31. — View Citation

Castillo MI, Cooke ML, Macfarlane B, Aitken LM. In ICU state anxiety is not associated with posttraumatic stress symptoms over six months after ICU discharge: A prospective study. Aust Crit Care. 2016 Aug;29(3):158-64. doi: 10.1016/j.aucc.2015.09.003. Epub 2015 Nov 6. — View Citation

Choi J, Hoffman LA, Schulz R, Tate JA, Donahoe MP, Ren D, Given BA, Sherwood PR. Self-reported physical symptoms in intensive care unit (ICU) survivors: pilot exploration over four months post-ICU discharge. J Pain Symptom Manage. 2014 Feb;47(2):257-70. doi: 10.1016/j.jpainsymman.2013.03.019. Epub 2013 Jul 12. — View Citation

de Azevedo JR, Montenegro WS, Rodrigues DP, de C Souza SC, Araujo VF, de Paula MP, Prazeres PH, da Luz Leitao A, Mendonca AV. Long-term cognitive outcomes among unselected ventilated and non-ventilated ICU patients. J Intensive Care. 2017 Feb 17;5:18. doi: 10.1186/s40560-017-0213-4. eCollection 2017. — View Citation

Glimelius Petersson C, Bergbom I, Brodersen K, Ringdal M. Patients' participation in and evaluation of a follow-up program following intensive care. Acta Anaesthesiol Scand. 2011 Aug;55(7):827-34. doi: 10.1111/j.1399-6576.2011.02474.x. Epub 2011 Jun 9. — View Citation

Hofhuis JG, Spronk PE, van Stel HF, Schrijvers AJ, Rommes JH, Bakker J. Experiences of critically ill patients in the ICU. Intensive Crit Care Nurs. 2008 Oct;24(5):300-13. doi: 10.1016/j.iccn.2008.03.004. Epub 2008 May 9. — View Citation

Hogberg KM, Sandman L, Nystrom M, Stockelberg D, Brostrom A. Caring Through Web-Based Communication: A Qualitative Evaluation of a Nursing Intervention to Create Holistic Well-Being Among Patients With Hematological Disease. J Holist Nurs. 2018 Sep;36(3):218-227. doi: 10.1177/0898010116667343. Epub 2016 Sep 22. — View Citation

Jensen JF, Thomsen T, Overgaard D, Bestle MH, Christensen D, Egerod I. Impact of follow-up consultations for ICU survivors on post-ICU syndrome: a systematic review and meta-analysis. Intensive Care Med. 2015 May;41(5):763-75. doi: 10.1007/s00134-015-3689-1. Epub 2015 Mar 3. Erratum In: Intensive Care Med. 2015 Jul;41(7):1391. — View Citation

Kroenke K, Spitzer RL, Williams JB, Lowe B. The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review. Gen Hosp Psychiatry. 2010 Jul-Aug;32(4):345-59. doi: 10.1016/j.genhosppsych.2010.03.006. Epub 2010 May 7. — View Citation

Myhren H, Ekeberg O, Toien K, Karlsson S, Stokland O. Posttraumatic stress, anxiety and depression symptoms in patients during the first year post intensive care unit discharge. Crit Care. 2010;14(1):R14. doi: 10.1186/cc8870. Epub 2010 Feb 8. — View Citation

Needham DM, Davidson J, Cohen H, Hopkins RO, Weinert C, Wunsch H, Zawistowski C, Bemis-Dougherty A, Berney SC, Bienvenu OJ, Brady SL, Brodsky MB, Denehy L, Elliott D, Flatley C, Harabin AL, Jones C, Louis D, Meltzer W, Muldoon SR, Palmer JB, Perme C, Robinson M, Schmidt DM, Scruth E, Spill GR, Storey CP, Render M, Votto J, Harvey MA. Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders' conference. Crit Care Med. 2012 Feb;40(2):502-9. doi: 10.1097/CCM.0b013e318232da75. — View Citation

Olsson SJ, Ekblom O, Andersson E, Borjesson M, Kallings LV. Categorical answer modes provide superior validity to open answers when asking for level of physical activity: A cross-sectional study. Scand J Public Health. 2016 Feb;44(1):70-6. doi: 10.1177/1403494815602830. Epub 2015 Sep 21. — View Citation

Peris A, Bonizzoli M, Iozzelli D, Migliaccio ML, Zagli G, Bacchereti A, Debolini M, Vannini E, Solaro M, Balzi I, Bendoni E, Bacchi I, Trevisan M, Giovannini V, Belloni L. Early intra-intensive care unit psychological intervention promotes recovery from post traumatic stress disorders, anxiety and depression symptoms in critically ill patients. Crit Care. 2011;15(1):R41. doi: 10.1186/cc10003. Epub 2011 Jan 27. Erratum In: Crit Care. 2011;15(2):418. Trevisan, Monica [added]. — View Citation

Pfoh ER, Wozniak AW, Colantuoni E, Dinglas VD, Mendez-Tellez PA, Shanholtz C, Ciesla ND, Pronovost PJ, Needham DM. Physical declines occurring after hospital discharge in ARDS survivors: a 5-year longitudinal study. Intensive Care Med. 2016 Oct;42(10):1557-1566. doi: 10.1007/s00134-016-4530-1. Epub 2016 Sep 16. — View Citation

Ramnarain, D., Rutten, A., Van der Nat, G. et al. The impact of post intensive care syndrome in patients surviving the ICU: the downside of ICU treatment. ICMx 3, A530 (2015) doi:10.1186/2197-425X-3-S1-A530

Samuelson K, Lundberg D, Fridlund B. Memory in relation to depth of sedation in adult mechanically ventilated intensive care patients. Intensive Care Med. 2006 May;32(5):660-7. doi: 10.1007/s00134-006-0105-x. Epub 2006 Mar 7. — View Citation

Schandl A, Bottai M, Holdar U, Hellgren E, Sackey P. Early prediction of new-onset physical disability after intensive care unit stay: a preliminary instrument. Crit Care. 2014 Jul 31;18(4):455. doi: 10.1186/s13054-014-0455-7. — View Citation

Sharshar T, Bastuji-Garin S, Stevens RD, Durand MC, Malissin I, Rodriguez P, Cerf C, Outin H, De Jonghe B; Groupe de Reflexion et d'Etude des Neuromyopathies En Reanimation. Presence and severity of intensive care unit-acquired paresis at time of awakening are associated with increased intensive care unit and hospital mortality. Crit Care Med. 2009 Dec;37(12):3047-53. doi: 10.1097/CCM.0b013e3181b027e9. — View Citation

Stjernsward S, Hansson L. User value and usability of a web-based mindfulness intervention for families living with mental health problems. Health Soc Care Community. 2017 Mar;25(2):700-709. doi: 10.1111/hsc.12360. Epub 2016 May 17. — View Citation

Sveen J, Low A, Dyster-Aas J, Ekselius L, Willebrand M, Gerdin B. Validation of a Swedish version of the Impact of Event Scale-Revised (IES-R) in patients with burns. J Anxiety Disord. 2010 Aug;24(6):618-22. doi: 10.1016/j.janxdis.2010.03.021. Epub 2010 Apr 12. — View Citation

Svenningsen H, Egerod I, Dreyer P. Strange and scary memories of the intensive care unit: a qualitative, longitudinal study inspired by Ricoeur's interpretation theory. J Clin Nurs. 2016 Oct;25(19-20):2807-15. doi: 10.1111/jocn.13318. Epub 2016 Jul 26. — View Citation

Vad är Intensivvård - SIR-Svenska Intensivvardsregistret [Internet]. [citerad 23 april 2018]. available at: http://www.icuregswe.org/sv/For-patienter/Vad-ar-Intensivvard/

Wolters AE, Slooter AJ, van der Kooi AW, van Dijk D. Cognitive impairment after intensive care unit admission: a systematic review. Intensive Care Med. 2013 Mar;39(3):376-86. doi: 10.1007/s00134-012-2784-9. Epub 2013 Jan 18. — View Citation

Wu RC, Delgado D, Costigan J, Maciver J, Ross H. Pilot study of an Internet patient-physician communication tool for heart failure disease management. J Med Internet Res. 2005 Mar 26;7(1):e8. doi: 10.2196/jmir.7.1.e8. — View Citation

* Note: There are 28 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Web-based follow up post-ICU impact on participants mental status concerning PTSD compared with no follow-up. Participant fill in questionnaire; Impact of event scale-revised (IES-R) which is screening for PTSD Questionnaire will be sent out at 2, 6 and 12 month post-ICU.
Primary Web-based follow up post-ICU impact on participants mental status regarding depression Patient Health Questionnaire (PHQ-9) which is screening for depression Questionnaire will be sent out at 2, 6 and 12 month post-ICU.
Primary Web-based follow up post-ICU impact on participants ability to deal with health related problems World Health Organization Disability Assessment Schedule (WHODAS 2.0) is a questionnaire which measure difficulties dealing with health-related problems. Questionnaire will be sent out at 2, 6 and 12 month post-ICU.
Primary Web-based follow-up post-ICU impact on participants physical activity level compared with no follow-up? Participant answer one questionnaire; level of physical activity pre- and post ICU. Questionnaires are sent out at 2, 6 and 12 month post-ICU.
Primary Participants will be asked what their opinions is on using web-based follow-up. Semi-structured form Questionnaire are sent at the end of the study-period.
Secondary Participants will be asked if they have unexpected hospital visit with health issues related to their ICU-stay. Question sent out: Have you had unexpected hospital visits with health issues related to their ICU-stay. This question is sent out at 2, 6 and 12 month post-ICU.
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