The feasibility and acceptability of a physician-led ICU follow-up service: A prospective cohort study

Wade Stedman; Lachlan Donaldson; Tessa Garside; Sarah Green; Stephanie F Donoghoe; Victoria E Whitfield; Frances Bass; Anthony Delaney; Naomi Hammond

doi:10.1016/j.aucc.2023.10.003

The feasibility and acceptability of a physician-led ICU follow-up service: A prospective cohort study

Aust Crit Care. 2024 Jan;37(1):3-11. doi: 10.1016/j.aucc.2023.10.003. Epub 2023 Dec 7.

Authors

Wade Stedman¹, Lachlan Donaldson², Tessa Garside³, Sarah Green⁴, Stephanie F Donoghoe⁵, Victoria E Whitfield⁵, Frances Bass², Anthony Delaney⁶, Naomi Hammond²

Affiliations

¹ Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia. Electronic address: wade.stedman@health.nsw.gov.au.
² Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia; Critical Care Program, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Australia.
³ Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia; Northern Clinical School, Sydney Medical School, University of Sydney, Australia.
⁴ Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia; Pharmacy Department, Royal North Shore Hospital, Sydney, Australia.
⁵ Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia.
⁶ Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia; Critical Care Program, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Australia; Northern Clinical School, Sydney Medical School, University of Sydney, Australia.

PMID: 38065794
DOI: 10.1016/j.aucc.2023.10.003

Abstract

Background: Increased recognition of post-intensive care syndrome has led to widespread development of intensive care follow-up services internationally.

Objective: The objective of this study was to determine the feasibility and acceptability of an intensive care unit (ICU) follow-up clinic in Australia for patients and their caregivers and to describe satisfaction with this service.

Methods: This was a prospective cohort study in a mixed tertiary ICU in Australia. Eligible patients were adults admitted to the ICU for 7 days or more and/or ventilated for 48 h or more, as well as their primary caregiver. Patients and their primary caregivers were invited to attend a follow-up clinic 4-8 weeks after hospital discharge. The clinic appointment was attended by an ICU physician and nurse, with multidisciplinary support. Feasibility and acceptability were defined as the proportion of clinic attendance and frequency of interventions initiated at the clinic. Satisfaction was measured by a 5-point satisfaction survey (very dissatisfied to very satisfied). The burden of ongoing disease was reported via multiple validated instruments.

Results: From April 2020-July 2021, 386 patients met the inclusion criteria. Only 146 patients were approached for consent due to site staffing limitations. Eighty-three patients and 32 caregivers consented to attend the clinic. Seventy percent (54/77) of patients attended scheduled appointments and 50% (16/32) of caregivers. For patients, 23 medical referrals were made, 8 patients had medication changes, and 10 patients were offered social work support. Satisfaction surveys were completed by 65% (35/54) of attending patients; 97% (34) patients reported either being 'very satisfied' or 'satisfied' with the service. All responding caregivers (10) were either 'very satisfied' or 'satisfied' with the clinic.

Conclusion: There were a large number of patients meeting the inclusion criteria to the ICU follow-up clinic, and clinic attendance was moderate for patients but lower for caregivers. Reported satisfaction with the service was high for both patients and their caregiver.

Keywords: Chronic; Critical care; Follow-up clinic; General practice and primary care; Intensive care unit; Pain.

MeSH terms

Adult
Critical Care*
Feasibility Studies
Follow-Up Studies
Humans
Intensive Care Units*
Prospective Studies