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Randomized Controlled Trial
. 2016 Nov;42(11):1733-1743.
doi: 10.1007/s00134-016-4522-1. Epub 2016 Sep 30.

A recovery program to improve quality of life, sense of coherence and psychological health in ICU survivors: a multicenter randomized controlled trial, the RAPIT study

Janet F Jensen  1 , Ingrid Egerod  2 , Morten H Bestle  3 , Doris F Christensen  3 , Ask Elklit  4 , Randi L Hansen  3 , Heidi Knudsen  5 , Louise B Grode  6 , Dorthe Overgaard  7
Affiliations
Randomized Controlled Trial

A recovery program to improve quality of life, sense of coherence and psychological health in ICU survivors: a multicenter randomized controlled trial, the RAPIT study

Janet F Jensen et al. Intensive Care Med. 2016 Nov.

Abstract

Purpose: The aim of this randomized controlled trial (RCT) was to test the effectiveness of a post-ICU recovery program compared to standard care during the first year after ICU discharge.

Methods: A pragmatic, non-blinded, multicenter, parallel-group RCT was conducted between December 2012 and December 2015, at ten intensive care units (ICUs) in Denmark. We randomly assigned 386 adult patients (≥18 years) after receiving mechanical ventilation (≥48 h) to standard care (SC) plus a nurse-led intensive care recovery program or standard care alone after ICU discharge (190 intervention, 196 SC). Primary outcome was health-related quality of life (HRQOL) at 12 months. Secondary outcomes were sense of coherence (SOC), anxiety, depression, and post-traumatic stress disorder (PTSD) assessed at 3 and 12 months after ICU discharge including utilization of healthcare services at 12 months.

Results: At 12 months, we found no differences in HRQOL between groups (mean difference in the Physical Component Summary score, 1.41 [95 % CI, -1.53 to 4.35; p = 0.35] (n = 235); and in the Mental Component Summary score, 1.92 [95 % CI, -1.06 to 4.90; p = 0.11] (n = 235). No differences were found on self-reported SOC (p = 0.63), anxiety (p = 0.68), depression (p = 0.67), PTSD (p = 0.27), or the utilization of healthcare services including rehabilitation. We found a difference on anxiety, when a cut-off point ≥11 was applied, in per protocol analysis of complete cases at 3 months favoring the intervention (8.8 % vs. 16.2 %, p = 0.04).

Conclusions: The tested recovery program was not superior to standard care during the first 12 months post-ICU.

Trial registration: The trial is registered at Clinicaltrials.gov, identification no. NCT01721239.

Keywords: Aftercare; Follow-up; ICU clinic; Intensive care; Multicenter randomized clinical controlled trial; Rehabilitation.

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