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WithdrawnNCT03284437ECTICUUpdated Nov 27, 2024

Pilot Study of Early Cognitive Training in the Intensive Care Unit

An interventional study of Early Cognitive Training in Intensive Care Units, Delirium, Cognitive Dysfunction, sponsored by Mount Carmel Health System. Withdrawn. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-11-27.

Sponsored by Mount Carmel Health System · Not applicable, Interventional, and Supportive care

Why this study was withdrawn
Logistical difficulties with implementing study.
Phase
Not applicable
Study type
Interventional
Enrollment
0
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this study is to see how early cognitive training (participation/involvement in activities to stimulate the brain) in the Intensive Care Unit (ICU) affects the number of patients who experience delirium (confusion) and cognitive impairment (problems with thinking). Reports have shown that 30% to 80% of all ICU patients will have some type of cognitive impairment: remembering, paying attention, solving problems, organizing, and working on complex tasks for some time after they leave the hospital.

Occupational therapy will do an assessment after an order is received from the doctor. The patient will be randomly placed into one of two groups. If the patient is in group A then they will continue with occupational therapy as normal. If the patient is assigned to group B then they and the family will have access to an activity cart found there in the ICU unit, directed by the nurses. The family will work with the patient on a daily basis to complete activities that are appropriate for the patient based on the occupational therapist's assessment. All patients in the study will receive medical care as usual.

Information about the patient's recovery in the hospital will be collected. In addition, patients and/or their family member will complete surveys at 6 months and 1 year after enrollment to see how they have recovered and if there are continuing issues. The two groups of patients, those who received the early cognitive training and those who did not, will be compared statistically to see if there are any differences in how well they recovered. Since this intervention involving family members working with the patient has not previously been evaluated, the study will also examine the feasibility of conducting these activities in the ICU setting.

Read the detailed description

This pilot study will assess the feasibility of implementing a randomized clinical trial testing an early cognitive training program for patients in the ICU. This cognitive training program was developed at Mount Carmel Health System in conjunction with occupational therapists and has not been previously evaluated.

Specific Aim 1: To evaluate whether the trial can accrue a sufficient number of patients within a reasonable time period to complete a randomized trial for efficacy.

Specific Aim 2: To evaluate whether the trial can be conducted as designed.

Specific Aim 3: To evaluate the likelihood that the trial can retain a sufficient number of patients through the end of follow-up.

Assessments include the Montreal Cognitive Assessment Test (MoCA), Richmond Agitation and Sedation Scale (RASS), Confusion Assessment Method in the ICU (CAM-ICU) and a validated quality of life survey.

02

Conditions studied

  • Intensive Care Units, Delirium, Cognitive Dysfunction
03

Who can participate

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

Inclusion criteria

  • Patient must be in the intensive care unit, i.e., either the surgical intensive care unit (SICU) or medical intensive care unit (MICU).
  • Patient must be ≥18 years old.
  • Predicted ICU length of stay greater than 3 days.
  • Patient with a RASS goal of -1 to +1 at time of enrollment.
  • Patient's family member(s) agree to do the cognitive training for a least one hour a day (a series of items meant to focus and stretch cognitive ability) while in the ICU. The hour can be done incrementally if needed. Family member should be ≥18 years old.
  • Family who can return to the hospital at the 6 month mark to take a final MOCA test and complete a survey.

Exclusion criteria

Exclusion Criteria:

  • Patient presently on Versed, Diprivan or Ativan drips.
  • Patient with a history of cognitive impairment, current psychiatric diagnosis and not stable on treatment, or developmental delay.
  • Patient with Alzheimer's or dementia.
  • Patient with known active substance abuse.
  • Patients without family support.
  • Patients without the ability to return to the hospital for the 6 month visit.
  • Patient with history of critical care illness within the last year from time of enrollment.
  • Patients who have been critically ill for greater than 72 hours.
  • Non-English speaking individuals restricting ability to follow instructions
04

Study design

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

Study arms

  • No intervention
    Usual Care

    Usual medical care provided to patients in the ICU.

  • Experimental
    Early Cognitive Training

    Usual medical care provided to patients in the ICU plus additional activities designed to engage the patient's attention and cognition. Activities are chosen by the family member from an activity cart according to the level designated by occupation therapy.

    Behavioral: Early Cognitive Training

Interventions

  • BehavioralEarly Cognitive Training

    Choose level of activity (e.g., coloring, holding objects) based on occupational therapist assessment.

05

What researchers measure

Primary outcomes

  1. Percent Enrollment

    Percent of eligible patients who are consented and enrolled into the study.

    Time frame: 3 Days

  2. Percent Receiving Intervention

    Percent of patients randomized to intervention who receive intervention

    Time frame: One month

Secondary outcomes

  1. Montreal Cognitive Assessment Score

    Change in Montreal Cognitive Assessment score from baseline to 6 months

    Time frame: 6 months

06

Study locations

No study locations are listed for this record.

07

References and documents

Individual participant data

Plan to share: No — No plans to share at this time. This intervention is being evaluated for feasibility.

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03284437
Lead sponsor
Mount Carmel Health System
Responsible party
Sponsor
First posted
Sep 15, 2017
Start date
Jan 5, 2021
Primary completion
Apr 26, 2021
Completion
Apr 26, 2021
Last update
Nov 27, 2024

Study contacts

Terri Swan, BSN
principal investigator · Mount Carmel Health System

Oversight

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

Not currently enrolling

This study is withdrawn, as verified in Jul 2021. You cannot join it, but the record below documents what was studied.

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