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CompletedNCT03264365RAPIT-IIUpdated Mar 7, 2018

The Effectiveness of a Post-ICU Recovery Program on Relatives

An interventional study of Intervention in Intensive Care Unit Syndrome and Relatives, sponsored by Holbaek Sygehus. Completed at 1 site in Denmark. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2018-03-07.

Sponsored by Holbaek Sygehus · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
181
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Relatives of intensive care patients are at risk of developing symptoms of anxiety, depression and post-traumatic stress disorder resulting in impaired health-related quality of life (HRQOL). Recovery programs have been tested, but its effectiveness is sparse. The hypothesis is that relatives to former intensive care patients will improve their HRQOL one year after intensive care. We want to determine whether relatives to former intensive care patient's benefits from a recovery programme with improved HRQOL, Sense Of Coherence (SOC) and symptoms of anxiety, depression and PTSD compared to standard care one year after intensive care.

Read the detailed description

Relatives of intensive care patients are affected of critical illness with symptoms of anxiety, depression and post-traumatic stress disorder resulting in impaired mental health. Recovery programs aimed at patients after a stay at the intensive care unit (ICU) have been tested and implemented, but the effectiveness is inconclusive, and on relatives sparse. The aim is to determine whether relatives to former intensive care patients benefits from a recovery programme with improved health-related quality of life (HRQOL), Sense Of Coherence (SOC), and symptoms of anxiety, depression, and PTSD compared to standard care during the first year after ICU discharge.

This was a sub-study of the "Recovery and Aftercare in Post-Intensive care Therapy patients" (RAPIT) trial; a pragmatic, non-blinded, multicentre, parallel-group, randomized controlled trial. We recruited patients and relatives concurrently during the RAPIT-trial study-period, and now we are doing analysis on relatives. We wants to include adult relatives defined by the patients from 10 Danish ICUs.

The study was powered to detect an effect size of a 5-point increase in the Medical Health Survey Short-Form 36 (SF-36) on the mental component score (MCS) in the intervention group at 12 months post-ICU. Power calculation was based on an expected distribution of MCS from a matched population with a mean of 36.7 (SD 11.7) from a similar study. With a statistical power of 80% and significance level of 0.05, we estimated that 86 relatives were needed in each group to complete follow-up.

The statistical analysis plan was based on intention-to-treat (ITT) as was per protocol (PP) analysis and investigating difference between intervention and controls. Relatives were considered to have received the intervention if the patient attended at least one of the three consultations, which accounted for the PP analysis.

02

Conditions studied

  • Intensive Care Unit Syndrome
  • Relatives

Keywords

  • Health-related quality of life
  • Anxiety
  • Depression
  • Post-traumatic stress disorder
  • Recovery programme
  • Rehabilitation
  • Follow-up programme
  • Aftercare
  • Randomized controlled Trial
  • Multicentre
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • 18 years of age or older
  • Defined by the patients

Exclusion criteria

Exclusion Criteria:

  • If the patients dropped out or died during the study period
04

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
181 participants (actual)

Study arms

  • Experimental
    Intervention

    Relatives participated actively in the one out of three consultation conducted by trained study nurses at two months after intensive care superimposed on standard care.

    Behavioral: Intervention

  • No intervention
    Standard care

    Relatives to former ICU patients, who had received standard care (SC) completed a questionnaire package at 3 and 12 months after the patient was discharged from intensive care. After enrollment were all contract handled by primary investigator.

Interventions

  • BehavioralIntervention

    Intervention (plus standard care) * Patients photographs during the ICU-stay, * Written information about life after ICU * First consultation face-to-face in hospital setting at three months after ICU * Visit ICU and photographs given * Consultations as needed

    Also known as: Standard care

05

What researchers measure

Primary outcomes

  1. Mental Component Score

    Health-related Quality of life using Short-form-36 questionnaire

    Time frame: 12 months after ICU

Secondary outcomes

  1. Mental Component Score

    Health-related Quality of life using Short-form-36 questionnaire

    Time frame: 3 months after ICU

  2. Physical Component Score

    Health-related Quality of life using Short-form-36 questionnaire

    Time frame: 3 months after ICU

  3. Physical Component Score

    Health-related Quality of life using Short-form-36 questionnaire

    Time frame: 12 months after ICU

  4. Anxiety

    Anxiety measured by Hospital Anxiety and Depression Scale (HADS)

    Time frame: 3 months after ICU

  5. Anxiety

    Anxiety measured by Hospital Anxiety and Depression Scale (HADS)

    Time frame: 12 months after ICU

  6. Depression

    Depression measured by Hospital Anxiety and Depression Scale (HADS)

    Time frame: 3 months after ICU

  7. Depression

    Depression measured by Hospital Anxiety and Depression Scale (HADS)

    Time frame: 12 months after ICU

  8. Post-traumatic stress Disorders

    Post-traumatic stress measured by the Harvard trauma Quesionnaire, ver. IV

    Time frame: 3 months after ICU

  9. Post-traumatic stress Disorders

    Post-traumatic stress measured by the Harvard trauma Quesionnaire, ver. IV

    Time frame: 12 months after ICU

  10. Sense of coherence

    Sense Of Coherence measured by the 13-item Orientation to Life questionnaire Questionnaire

    Time frame: 3 months after ICU

  11. Sense of coherence

    Sense Of Coherence measured by the 13-item Orientation to Life questionnaire Questionnaire

    Time frame: 12 months after ICU

06

Study locations

1 site
  • Holbæk Hospital
    Holbæk, Sjælland 4300, Denmark
07

References and documents

Publications

  • Jensen JF, Egerod I, Bestle MH, Christensen DF, Elklit A, Hansen RL, Knudsen H, Grode LB, Overgaard D. 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. Intensive Care Med. 2016 Nov;42(11):1733-1743. doi: 10.1007/s00134-016-4522-1. Epub 2016 Sep 30. PubMed 27695894 ↗

Individual participant data

Plan to share: Undecided — Agreement of collaboration between sites have determinated that abstracts should be evaluated by the RAPIT-steering committee prior data are shared with other researchers.

08

Registry details

Key details

Study ID
NCT03264365
Lead sponsor
Holbaek Sygehus
Collaborators
Nordsjaellands Hospital, Herlev Hospital, Horsens Hospital, Nykøbing Falster County Hospital, Naestved Hospital, Rigshospitalet, Denmark, Aabenraa Hospital, Sonderborg Hospital, Esbjerg Hospital - University Hospital of Southern Denmark, Svendborg Hospital
Responsible party
Janet Froulund Jensen (PHD, Holbaek Sygehus) — Principal investigator
First posted
Aug 29, 2017
Start date
Dec 15, 2012
Primary completion
Dec 31, 2015
Completion
Mar 6, 2018
Last update
Mar 7, 2018

Study contacts

RAPIT Steering Committee
study chair · Region of Copenhagen Capital and Region of Zealand

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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