Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2019 Feb;45(2):223-235.
doi: 10.1007/s00134-018-05511-y. Epub 2019 Jan 30.

Tailored multicomponent program for discomfort reduction in critically ill patients may decrease post-traumatic stress disorder in general ICU survivors at 1 year

Pierre Kalfon  1   2 , Marine Alessandrini  3 , Mohamed Boucekine  3 , Stéphanie Renoult  4 , Marie-Agnès Geantot  5 , Stéphanie Deparis-Dusautois  6 , Audrey Berric  7 , Olivier Collange  8 , Bernard Floccard  9 , Olivier Mimoz  10 , Amour Julien  11 , René Robert  12 , Juliette Audibert  13 , Anne Renault  14 , Arnaud Follin  15 , Didier Thevenin  16 , Nathalie Revel  17 , Marion Venot  18 , René-Gilles Patrigeon  19 , Thomas Signouret  20 , Mélanie Fromentin  21 , Tarek Sharshar  22 , Coralie Vigne  23 , Julien Pottecher  24 , Quentin Levrat  25 , Achille Sossou  26 , Maïté Garrouste-Orgeas  27 , Jean-Pierre Quenot  28 , Claire Boulle  29 , Elie Azoulay  18 , Karine Baumstarck  3 , Pascal Auquier  3 ; IPREA-AQVAR Study Group
Collaborators, Affiliations
Observational Study

Tailored multicomponent program for discomfort reduction in critically ill patients may decrease post-traumatic stress disorder in general ICU survivors at 1 year

Pierre Kalfon et al. Intensive Care Med. 2019 Feb.

Abstract

Purpose: Reducing discomfort in the intensive care unit (ICU) should have a positive effect on long-term outcomes. This study assessed whether a tailored multicomponent program for discomfort reduction was effective in reducing post-traumatic stress disorder (PTSD) symptoms at 1 year in general ICU survivors.

Methods: This study is a prospective observational comparative effectiveness cohort study involving 30 ICUs. It was an extension of the IPREA3 study, a cluster-randomized controlled trial designed to assess the efficacy of a tailored multicomponent program to reduce discomfort in critically ill patients. The program included assessment of ICU-related self-perceived discomforts, immediate and monthly feedback to the healthcare team, and site-specific tailored interventions. The exposure was the implementation of this program. The eligible patients were exposed versus unexposed general adult ICU survivors. The prevalence of substantial PTSD symptoms at 1 year was assessed based on the Impact of Event Scale-Revised (IES-R).

Results: Of the 1537 ICU survivors included in the study, 475 unexposed patients and 344 exposed patients had follow-up data at 1 year: 57 (12.0%) and 21 (6.1%) presented with PTSD at 1 year, respectively (p = 0.004). Considering the clustering and after adjusting for age, gender, McCabe classification, and ICU-related self-perceived overall discomfort score, exposed patients were significantly less likely than unexposed patients to have substantial PTSD symptoms at 1 year (p = 0.015).

Conclusions: Implementation of a tailored multicomponent program in the ICU that has proved to be effective for reducing self-perceived discomfort in general adult ICU survivors also reduced the prevalence of substantial PTSD symptoms at 1 year.

Trial registration: ClinicalTrials.gov identifier NCT02762409.

Keywords: Critical care; Discomfort; ICU; Patient-reported outcome; Post-traumatic stress disorder; Tailored program.

PubMed Disclaimer

References

    1. Crit Care Med. 1998 Apr;26(4):651-9 - PubMed
    1. Behav Res Ther. 2003 Dec;41(12):1489-96 - PubMed
    1. Am J Respir Crit Care Med. 2016 Jun 15;193(12):1373-81 - PubMed
    1. Lancet. 1999 Aug 14;354(9178):571-2 - PubMed
    1. Am J Crit Care. 1995 Jan;4(1):71-6 - PubMed

Publication types

MeSH terms

Associated data

LinkOut - more resources