Enhanced Recovery After Intensive Care (ERIC)

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Charité University Medicine Berlin

Status

Completed

Conditions

Critical Illness

Treatments

Behavioral: Tele-ICU
Other: ICU Usual Care

Study type

Interventional

Funder types

Other

Identifiers

NCT03671447
ERIC

Details and patient eligibility

About

The primary objective of the multi-center stepped-wedge cluster-randomized controlled trial ERIC is to evaluate the effects of a multi-component telemedicine-based intervention delivered by the ICU on the adherence to quality indicators (QI) in intensive care medicine compared to usual care. Critically ill patients treated on the interventional condition receive daily tele-medical rounds during their ICU stay. Further secondary objectives are to demonstrate whether the intervention improves patient outcomes 3 and 6 months post ICU discharge, compared to usual care.

Full description

Rationale: Survivors of critical illness frequently develop long-term mental, cognitive, and/or physical impairments summarized as Post Intensive Care Syndrome (PICS). On the national society level, Germany uses 10 core QIs that are evidence-based to improve treatment quality at ICUs. Objective: To investigate whether a tele-medical intervention delivered at ICU improves the adherence to established evidence-based QIs in intensive care medicine compared to the adherence at ICUs delivering usual care. Study design: ERIC is a stepped-wedge cluster-randomized controlled quality improvement trial with participating ICUs crossing over from usual care to a multifaceted e-health intervention. After the rollout, all recruiting sites will have implemented the experimental intervention for at least 4 months. Follow-up assessments on the patient-level at month 3 and 6 after ICU discharge (index stay) will be conducted in the outpatient or inpatient setting (dependent on the patient's health status). Study population: Critically ill patients covered by statutory health insurance treated at participating ICUs in Berlin and Brandenburg, Germany. It is planned to recruit 1431 study patients within 16 months. Intervention: Complex telemedicine-based intervention incorporating the use of e-health technologies (virtual care), supported by blended learning of ICU staff prior to the site's crossover. Comparison: Intensive care according to current practice. Endpoints: Eight co-primary endpoints will be specified. A primary efficacy endpoint is the adherence to a single QI in intensive care medicine (definition according to Kumpf O. et al., 2017) measured on a daily basis, on a patient-level. Sedation and delirium management in Frankfurt/Oder before and after implementation of the new form of care ERIC - (SeDelFIN) In this sub-project it should be evaluated how the implementation of the evidence-based standard for delirium, analgesia and pain management changes changed after the introduction of the new form of care. For this purpose, the patient files (which are available in paper form) of all patients who were admitted to the intensive care unit of the Department of Anaesthesiology, Intensive Care Medicine and Pain therapy at the Frankfurt/Oder Clinic (study center) were analyzed by Wilma Klink.

Enrollment

1,463 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Patient Level:

Inclusion Criteria:

  • Age ≥ 18 years
  • Expected to receive treatment in a medical or surgical ICU connected to the project for more than 24 hours
  • Coverage by a German statutory health insurance company
  • Written informed consent of patient or legal representative

Exclusion Criteria:

• Age < 18 years

Institutional level:

Inclusion Criteria:

  • Located in the Berlin/Brandenburg metropolitan region
  • Adherence to general legal obligations to participate in the study funded by the German Innovation Fund and participate in the respective contracts.
  • Adherence to cluster-randomization

Exclusion Criteria:

• No intensive care beds available

Trial design

1,463 participants in 2 patient groups

ICU usual care
Active Comparator group
Description:
control condition
Treatment:
Other: ICU Usual Care
Intervention "ERIC"
Experimental group
Description:
intervention condition
Treatment:
Behavioral: Tele-ICU

Trial contacts and locations

0

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Data sourced from clinicaltrials.gov

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