Tailored multicomponent program for discomfort reduction in critically ill patients may decrease post-traumatic stress disorder in general ICU survivors at 1 year - Archive ouverte HAL
Article Dans Une Revue Intensive Care Medicine Année : 2019

Tailored multicomponent program for discomfort reduction in critically ill patients may decrease post-traumatic stress disorder in general ICU survivors at 1 year

1 Hôpital Louis Pasteur [Chartres]
2 CEReSS - Centre d'études et de recherche sur les services de santé et la qualité de vie
3 Hôpital Ambroise Paré [AP-HP]
4 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
5 Centre hospitalier de Troyes
6 Centre Hospitalier Intercommunal Toulon la Seyne sur mer
7 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
8 Hôpital Edouard Herriot [CHU - HCL]
9 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
10 PHAR [Poitiers] - Pharmacologie des anti-infectieux
11 UFR Santé [Poitiers] - Université de Poitiers – UFR Santé [Faculté de Médecine et de Pharmacie]
12 CHU Pitié-Salpêtrière [AP-HP]
13 CHU - BREST - Réa Med - CHRU Brest - Service de Réanimation Médicale
14 Service d'Anesthésie-Réanimation [CHU HEGP]
15 Centre Hospitalier de Lens
16 CHU - Hôpital Pasteur [Nice]
17 AP-HP - Hopital Saint-Louis [AP-HP]
18 CHA - Centre hospitalier d'Auxerre
19 HEM - Hôpital Européen de Marseille
20 Hôpital Cochin [AP-HP]
21 Service médical des soins intensifs [CHU Raymond Poincaré]
22 Service Anesthésie et Réanimation [Hôpital Nord - APHM]
23 Hôpital de Hautepierre [Strasbourg]
24 Hopital Saint-Louis [La Rochelle]
25 Department of Anesthesiology and Critical Care Medicine, Emile-Roux general hospital, Le Puy-en-Velay
26 Centre hospitalier Saint-Joseph [Paris]
27 Service de Réanimation Médicale (CHU de Dijon)
28 Centre Hospitalier [Douai, Nord]
Arnaud Follin
  • Fonction : Auteur
  • PersonId : 922423
Julien Pottecher
Élie Azoulay

Résumé

Purpose: Reducing discomfort in the intensive care unit (ICU) should have a positive effect on long-term outcomes. This study assessed whether a tailored multicomponent program for discomfort reduction was effective in reducing post-traumatic stress disorder (PTSD) symptoms at 1 year in general ICU survivors. Methods: This study is a prospective observational comparative effectiveness cohort study involving 30 ICUs. It was an extension of the IPREA3 study, a cluster-randomized controlled trial designed to assess the efficacy of a tailored multicomponent program to reduce discomfort in critically ill patients. The program included assessment of ICU-related self-perceived discomforts, immediate and monthly feedback to the healthcare team, and site-specific tailored interventions. The exposure was the implementation of this program. The eligible patients were exposed versus unexposed general adult ICU survivors. The prevalence of substantial PTSD symptoms at 1 year was assessed based on the Impact of Event Scale-Revised (IES-R). Results: Of the 1537 ICU survivors included in the study, 475 unexposed patients and 344 exposed patients had follow-up data at 1 year: 57 (12.0%) and 21 (6.1%) presented with PTSD at 1 year, respectively (p = 0.004). Considering the clustering and after adjusting for age, gender, McCabe classification, and ICU-related self-perceived overall discomfort score, exposed patients were significantly less likely than unexposed patients to have substantial PTSD symptoms at 1 year (p = 0.015). Conclusions: Implementation of a tailored multicomponent program in the ICU that has proved to be effective for reducing self-perceived discomfort in general adult ICU survivors also reduced the prevalence of substantial PTSD symptoms at 1 year.
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Dates et versions

hal-02540255 , version 1 (10-04-2020)

Identifiants

Citer

Pierre Kalfon, Marine Alessandrini, Mohamed Boucekine, Stéphanie Renoult, Marie-Agnès Geantot, et al.. Tailored multicomponent program for discomfort reduction in critically ill patients may decrease post-traumatic stress disorder in general ICU survivors at 1 year. Intensive Care Medicine, 2019, 45 (2), pp.223-235. ⟨10.1007/s00134-018-05511-y⟩. ⟨hal-02540255⟩
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