Feasibility of Telephone Follow-Up after Critical Care Discharge

Abstract

Background: Critical care has evolved from a primary focus on short-term survival, with greater attention being placed on longer-term health care outcomes. It is not known how best to implement follow-up after critical care discharge. Study aims were to (1) assess the uptake and feasibility of telephone follow-up after a critical care stay and (2) profile overall physical status and recovery during the sub-acute recovery period using a telephone follow-up assessment. Methods: Adults who had been admitted to critical care units of St. James's Hospital, Dublin, for >72 h were followed up by telephone 3-9 months post discharge from critical care. The telephone assessment consisted of a battery of questionnaires (including the SF-36 questionnaire and the Clinical Frailty Scale) and examined quality of life, frailty, employment status, and feasibility of telephone follow-up. Results: Sixty five percent (n = 91) of eligible participants were reachable by telephone. Of these, 80% (n = 73) participated in data collection. Only 7% (n = 5) expressed a preference for face-to-face hospital-based follow-up as opposed to telephone follow-up. For the SF-36, scores were lower in a number of physical health domains as compared to population norms. Frailty increased in 43.2% (n = 32) of participants compared to pre-admission status. Two-thirds (n = 48) reported being >70% physically recovered. Conclusion: Results showed that telephone follow-up is a useful contact method for a typically hard-to-reach population. Deficits in physical health and frailty were noted in the sub-acute period after discharge from critical care.

Keywords: critical care; frailty; intensive care; quality of life; recovery; telephone.

Figure 1

Flow of participants through the study. ICU: Intensive care unit, HDU: High-dependency unit.

Figure 2

Pie chart of phone versus face-to-face person follow-up preference, participant numbers included.

Figure 3

Polar plot HRQoL (SF-36) values for participants (solid red line) compared to population norms from the United States, the United Kingdom, France, and Norway. The confidence interval is indicted by the broken red line (confidence interval of study participants is the inner red broken line, confidence interval of populations normative values is the outer broken red line).

Figure 4

CFS estimated pre-admission to critical care and current status (3–9 months after hospital discharge). CFS: Clinical Frailty Score.