PMID- 29186177
OWN - NLM
STAT- MEDLINE
DCOM- 20171226
LR  - 20181113
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 11
DP  - 2017
TI  - Intensive Care Syndrome: Promoting Independence and Return to Employment 
      (InS:PIRE). Early evaluation of a complex intervention.
PG  - e0188028
LID - 10.1371/journal.pone.0188028 [doi]
LID - e0188028
AB  - BACKGROUND: Many patients suffer significant physical, social and psychological 
      problems in the months and years following critical care discharge. At present, 
      there is minimal evidence of any effective interventions to support this patient 
      group following hospital discharge. The aim of this project was to understand the 
      impact of a complex intervention for ICU survivors. METHODS: Quality improvement 
      project conducted between September 2014 and June 2016, enrolling 49 selected 
      patients from one ICU in Scotland. To evaluate the impact of this programme 
      outcomes were compared to an existing cohort of patients from the same ICU from 
      2008-2009. Patients attended a five week peer supported rehabilitation programme. 
      This multidisciplinary programme included pharmacy, physiotherapy, nursing, 
      medical, and psychology input. The primary outcome in this evaluation was the 
      EQ-5D, a validated measure of health-related quality of life. The minimally 
      clinically important difference (MCID) in the EQ-5D is 0.08. We also measured 
      change in self-efficacy over the programme duration. Based on previous research, 
      this study utilised a 2.4 (6%) point change in self-efficacy scores as a MCID. 
      RESULTS: 40 patients (82%) completed follow-up surveys at 12 months. After 
      regression adjustment for those factors known to impact recovery from critical 
      care, there was a 0.07-0.16 point improvement in quality of life for those 
      patients who took part in the intervention compared to historical controls from 
      the same institution, depending on specific regression strategy used. 
      Self-efficacy scores increased by 2.5 points (6.25%) over the duration of the 
      five week programme (p = 0.003), and was sustained at one year post intervention. 
      In the year following ICU, 15 InS:PIRE patients returned to employment or 
      volunteering roles (88%) compared with 11 (46%) in the historical control group 
      (p = 0.15). CONCLUSIONS AND RELEVANCE: This historical control study suggests 
      that a complex intervention may improve quality of life and self-efficacy in 
      survivors of ICU. A larger, multi-centre study is needed to investigate this 
      intervention further.
FAU - McPeake, Joanne
AU  - McPeake J
AUID- ORCID: 0000-0001-8206-6801
AD  - University of Glasgow, School of Medicine, Dentistry and Nursing, Glasgow, 
      Scotland, United Kingdom.
AD  - NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, Intensive Care Unit, 
      Glasgow, United Kingdom.
FAU - Shaw, Martin
AU  - Shaw M
AD  - University of Glasgow, School of Medicine, Dentistry and Nursing, Glasgow, 
      Scotland, United Kingdom.
AD  - NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, Clinical Physics 
      Department, Glasgow, Scotland, United Kingdom.
FAU - Iwashyna, Theodore J
AU  - Iwashyna TJ
AD  - Center for Clinical Management Research, VA Ann Arbor Health System, Ann Arbor, 
      Michigan, United States of America.
AD  - Department of Internal Medicine, Division of Pulmonary and Critical Care, 
      University of Michigan, Ann Arbor, Michigan, United States of America.
FAU - Daniel, Malcolm
AU  - Daniel M
AD  - NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, Intensive Care Unit, 
      Glasgow, United Kingdom.
FAU - Devine, Helen
AU  - Devine H
AD  - NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, Intensive Care Unit, 
      Glasgow, United Kingdom.
FAU - Jarvie, Lyndsey
AU  - Jarvie L
AD  - NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, Intensive Care Unit, 
      Glasgow, United Kingdom.
FAU - Kinsella, John
AU  - Kinsella J
AD  - University of Glasgow, School of Medicine, Dentistry and Nursing, Glasgow, 
      Scotland, United Kingdom.
AD  - NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, Intensive Care Unit, 
      Glasgow, United Kingdom.
FAU - MacTavish, Pamela
AU  - MacTavish P
AD  - University of Glasgow, School of Medicine, Dentistry and Nursing, Glasgow, 
      Scotland, United Kingdom.
FAU - Quasim, Tara
AU  - Quasim T
AD  - University of Glasgow, School of Medicine, Dentistry and Nursing, Glasgow, 
      Scotland, United Kingdom.
AD  - NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, Intensive Care Unit, 
      Glasgow, United Kingdom.
LA  - eng
PT  - Journal Article
DEP - 20171129
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adult
MH  - *Critical Care
MH  - *Employment
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Discharge
MH  - Quality of Life
MH  - *Return to Work
MH  - Self Efficacy
PMC - PMC5706708
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2017/12/01 06:00
MHDA- 2017/12/27 06:00
PMCR- 2017/11/29
CRDT- 2017/11/30 06:00
PHST- 2017/05/29 00:00 [received]
PHST- 2017/10/29 00:00 [accepted]
PHST- 2017/11/30 06:00 [entrez]
PHST- 2017/12/01 06:00 [pubmed]
PHST- 2017/12/27 06:00 [medline]
PHST- 2017/11/29 00:00 [pmc-release]
AID - PONE-D-17-20337 [pii]
AID - 10.1371/journal.pone.0188028 [doi]
PST - epublish
SO  - PLoS One. 2017 Nov 29;12(11):e0188028. doi: 10.1371/journal.pone.0188028. 
      eCollection 2017.