Intensive Communication for Chronically Critically Ill

Not Applicable

Completed

• Conditions: Critical Care
• Interventions: Other: Intensive Communication System

• Registration Number: NCT01057238
• Lead Sponsor: Case Western Reserve University

Brief Summary

This study was a trial of a formal system of family meetings to support family decision makers of chronically critically ill patients in the intensive care unit.

Detailed Description

Formal family meetings have been recommended as a useful approach to assist in goal setting, facilitate decision making, and reduce use of ineffective resources in the ICU. We implemented an "intensive communication system" to test the effect of regular, structured formal family meetings on patient outcomes among long-stay ICU patients

The design was a pre-post, tandem assignment of patients (n=217) receiving usual care and communication, followed by enrollment of intervention patients (n=354), from 5 ICUs. The "intensive communication system" included: (1) family meeting within 5 days of ICU admission and weekly thereafter; (2) each meeting addressed medical update, values and preferences, goals of care; treatment plan, and milestones for judging effectiveness of treatment.

We measured differences between control and intervention patients in indicators of aggressiveness of care or timing of treatment limitation decisions (ICU mortality, LOS, duration of ventilation, treatment limitation orders, or use of tracheostomy or percutaneous gastrostomy). Difference in outcomes among patients who died or who had treatment limitation orders, comparing control and intervention groups, was also examined.

Study Timeline

• Study Start: 2005-11
• Primary Completion: 2008-04
• Study Completion: 2008-05
• Study First Submitted: 2010-01-26
• Study First Submitted QC: 2010-01-26
• Study First Posted: 2010-01-27
• Status Verified: 2016-07
• Last Update Submitted: 2016-07-25
• Last Update Posted: 2016-07-27

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 571

Inclusion Criteria

• cognitively impaired mechanical ventilation >3 days not expected to be discharged before 5 days having a family decision maker

Exclusion Criteria

• no family member hospice referral

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Intensive Communication	Intensive Communication System	regular family meeting every 5 days.

Primary Outcome Measures

Name	Time	Method
length of stay and depression	ICU admission, Day 5, discharge, and 2 months

Trial Locations

Locations (1)

University Hosptials Case Medical center; 🇺🇸 Cleveland, Ohio, United States