Vanderbilt ICU Recovery Program Pilot Trial (VIP)

Vanderbilt University Medical Center

Status: Completed

Conditions: Intensive Care Neurological Disorder; Intensive Care Psychiatric Disorder (Diagnosis); Intensive Care Unit Syndrome; Intensive Care (ICU) Myopathy

Treatments: Other: VANDERBILT ICU RECOVERY PROGRAM

Study type: Interventional

Funder types: Other

Identifiers

NCT03124342

170126

Details and patient eligibility

About

Every year, millions of Americans are admitted to the intensive care unit. Due to advances in critical care, mortality rates are decreasing, increasing the number of ICU survivors. Survivors of critical illness, however, often face physical, functional, and cognitive deficits that place them at risk for a cycle of re-hospitalization that frequently culminates in premature death. Moreover, post-ICU interventions may be resource-intensive and may be most cost-effective only in a subgroup of patients at highest risk. Whether a multi-disciplinary program to facilitate recovery from critical illness can prevent hospital readmission and improve quality of life among high-risk ICU survivors remains unknown. The primary aim of this pilot is to examine the feasibility of implementing a multidisciplinary ICU Recovery Program and the influence of such a program on process measures including contact with the ICU recovery team and attendance of ICU recovery clinic. The secondary aims are to compare the effect of an ICU Recovery Program on 30-day same-hospital readmission and other clinical outcomes.

Enrollment: 232 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Age ≥ 18 years
2. Admitted to the Medical Intensive Care Unit (MICU) at Vanderbilt University Medical Center for at least 48 hours
3. Estimated risk of 30-day same-hospital readmission greater than 15%
4. Not previously enrolled in the study.

Exclusion criteria

1. Long-term residence at a skilled nursing facility
2. Long-term mechanical ventilation prior to admission
3. Solid organ or stem cell transplantation
4. Recorded primary residency > 200 miles from Vanderbilt
5. Comfort care only

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

232 participants in 2 patient groups

VANDERBILT ICU RECOVERY PROGRAM (VIP)

Experimental group

Description:

Patients assigned to the Vanderbilt ICU Recovery Program (VIP) group will receive the components of the ICU Recovery Program intervention.

Treatment:

Other: VANDERBILT ICU RECOVERY PROGRAM

Usual care

No Intervention group

Description:

Patients in the usual care group will receive care as dictated by their clinical team. In usual care in the study institution, patients frequently receive medication reconciliation by and ICU pharmacist at the time of transfer out of the ICU to the hospital ward, medication reconciliation by a physician at the time of hospital discharge, and follow up with their primary care physician within two weeks of hospital discharge. Usual care does not currently include an in-person assessment of the patient's cognitive and functional status or anticipated post-ICU needs by a nurse practitioner between ICU transfer and hospital discharge, access to a 24/7 contact line after hospital discharge, or assessment in a multi-disciplinary ICU Recovery Clinic.