Title |
A tailored multicomponent program to reduce discomfort in critically ill patients: a cluster-randomized controlled trial
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Published in |
Intensive Care Medicine, November 2017
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DOI | 10.1007/s00134-017-4991-x |
Pubmed ID | |
Authors |
Pierre Kalfon, Karine Baumstarck, Philippe Estagnasie, Marie-Agnès Geantot, Audrey Berric, Georges Simon, Bernard Floccard, Thomas Signouret, Mohamed Boucekine, Mélanie Fromentin, Martine Nyunga, Achille Sossou, Marion Venot, René Robert, Arnaud Follin, Juliette Audibert, Anne Renault, Maïté Garrouste-Orgeas, Olivier Collange, Quentin Levrat, Isabelle Villard, Didier Thevenin, Julien Pottecher, René-Gilles Patrigeon, Nathalie Revel, Coralie Vigne, Elie Azoulay, Olivier Mimoz, Pascal Auquier, on behalf of the IPREA Study group |
Abstract |
Critically ill patients are exposed to stressful conditions and experience several discomforts. The primary objective was to assess whether a tailored multicomponent program is effective for reducing self-perceived discomfort. In a cluster-randomized two-arm parallel trial, 34 French adult intensive care units (ICUs) without planned interventions to reduce discomfort were randomized, 17 to the arm including a 6-month period of program implementation followed by a 6-month period without the program (experimental group), and 17 to the arm with an inversed sequence (control group). The tailored multicomponent program consisted of assessment of ICU-related self-perceived discomforts, immediate and monthly feedback to healthcare teams, and site-specific tailored interventions. The primary outcome was the overall discomfort score derived from the 16-item IPREA questionnaire (0, minimal, 100, maximal overall discomfort) and the secondary outcomes were the discomfort scores of each IPREA item. IPREA was administered on the day of ICU discharge with a considered timeframe from the ICU admission until ICU discharge. During a 1-month assessment period, 398 and 360 patients were included in the experimental group and the control group, respectively. The difference (experimental minus control) of the overall discomfort score between groups was - 7.00 (95% CI - 9.89 to - 4.11, p < 0.001). After adjustment (age, gender, ICU duration, mechanical ventilation duration, and type of admission), the program effect was still positive for the overall discomfort score (difference - 6.35, SE 1.23, p < 0.001) and for 12 out of 16 items. This tailored multicomponent program decreased self-perceived discomfort in adult critically ill patients. Clinicaltrials.gov Identifier NCT02442934. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 11 | 24% |
United States | 3 | 7% |
Mexico | 2 | 4% |
France | 2 | 4% |
Italy | 1 | 2% |
Colombia | 1 | 2% |
Chile | 1 | 2% |
Uruguay | 1 | 2% |
Ecuador | 1 | 2% |
Other | 4 | 9% |
Unknown | 18 | 40% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 30 | 67% |
Scientists | 8 | 18% |
Practitioners (doctors, other healthcare professionals) | 7 | 16% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 78 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 9 | 12% |
Student > Master | 9 | 12% |
Student > Bachelor | 6 | 8% |
Student > Postgraduate | 5 | 6% |
Student > Doctoral Student | 4 | 5% |
Other | 15 | 19% |
Unknown | 30 | 38% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 17 | 22% |
Nursing and Health Professions | 16 | 21% |
Neuroscience | 4 | 5% |
Psychology | 2 | 3% |
Economics, Econometrics and Finance | 1 | 1% |
Other | 6 | 8% |
Unknown | 32 | 41% |