Intensive Care Unit (ICU) Diary Project

NCT ID: NCT04305353

Last Updated: 2021-04-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-09-26

Study Completion Date

2020-09-01

Brief Summary

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Psychological morbidity in both patients and family members related to the intensive care unit (ICU) experience is an often overlooked, and potentially persistent, healthcare problem recognized by the Society of Critical Care Medicine as Post-intensive Care Syndrome (PICS). ICU diaries are an intervention increasingly under study with potential to mitigate ICU-related psychological morbidity, include ICU-related PTSD (post-traumatic stress disorder), depression and anxiety.

Detailed Description

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The investigators compared the efficacy of the ICU diary, prospectively written by third-parties during the patient's intensive care course, versus education-alone, on reducing acute PTSD symptoms after discharge. Patients with an ICU stay greater than 72 hours, and who were intubated and mechanically ventilated over 24 hours, were recruited and randomized to either receive a diary at bedside with psychoeducation, or psychoeducation alone. Intervention patients received their ICU diary within the first week of admission into the intensive care unit. Psychometric testing with IES-R, PHQ-8, HADS and GAD-7 was conducted at weeks 4, 12, and 24 after ICU discharge.

Conditions

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PTSD Post ICU Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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ICU Diary Group

Patients randomized to this group receive the ICU diary, along with PTSD education

Group Type EXPERIMENTAL

Diary (blank journal) plus PTSD psycho-education

Intervention Type OTHER

A blank journal where a prospective account of a patient's ICU course (everyday events) can be documented by family members and healthcare providers

PTSD psycho-education alone

Intervention Type OTHER

We administered a pamphlet to patients with information regarding PTSD symptoms, potential psychiatric complications after discharge, and available mental health resources.

References for our education include the following which are included in our references section: Jensen 2015, Jones 2010, Knowles 2009, Parker 2015, Wintermann 2015.

PTSD Education-only Group

Control Group: patients randomized to this group only receive PTSD education

Group Type OTHER

PTSD psycho-education alone

Intervention Type OTHER

We administered a pamphlet to patients with information regarding PTSD symptoms, potential psychiatric complications after discharge, and available mental health resources.

References for our education include the following which are included in our references section: Jensen 2015, Jones 2010, Knowles 2009, Parker 2015, Wintermann 2015.

Interventions

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Diary (blank journal) plus PTSD psycho-education

A blank journal where a prospective account of a patient's ICU course (everyday events) can be documented by family members and healthcare providers

Intervention Type OTHER

PTSD psycho-education alone

We administered a pamphlet to patients with information regarding PTSD symptoms, potential psychiatric complications after discharge, and available mental health resources.

References for our education include the following which are included in our references section: Jensen 2015, Jones 2010, Knowles 2009, Parker 2015, Wintermann 2015.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* admitted to the intensive care unit for at least 72 hours
* sedated and mechanically ventilated for at least 24 hours.
* available over-the-phone, up to 6 months post-ICU discharge

Exclusion Criteria

* any patients who do not voluntarily agree to participate
* not fluent in the English language
* patients who have stayed in the ICU for less than 72 hours
* patients who have been sedated and mechanically ventilated for less than 24 hours
* patients with pre-existing severe psychotic illness, bipolar disorder, substance use disorder, PTSD, stroke, traumatic brain injury, neurocognitive impairment, or intellectual disability
* patients with no phone number or reliable contact information for the sake of follow-up
* prisoners
* pregnant patients
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Arnold P. Gold Foundation

OTHER

Sponsor Role collaborator

Tulane University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rachel Hammer, MD, MFA

Role: PRINCIPAL_INVESTIGATOR

Tulane University School of Medicine

George Sayde, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Tulane University School of Medicine

Locations

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Tulane University School of Medicine

New Orleans, Louisiana, United States

Site Status

Countries

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United States

References

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Parker AM, Sricharoenchai T, Raparla S, Schneck KW, Bienvenu OJ, Needham DM. Posttraumatic stress disorder in critical illness survivors: a metaanalysis. Crit Care Med. 2015 May;43(5):1121-9. doi: 10.1097/CCM.0000000000000882.

Reference Type BACKGROUND
PMID: 25654178 (View on PubMed)

Wintermann GB, Brunkhorst FM, Petrowski K, Strauss B, Oehmichen F, Pohl M, Rosendahl J. Stress disorders following prolonged critical illness in survivors of severe sepsis. Crit Care Med. 2015 Jun;43(6):1213-22. doi: 10.1097/CCM.0000000000000936.

Reference Type BACKGROUND
PMID: 25760659 (View on PubMed)

Jones C, Backman C, Capuzzo M, Egerod I, Flaatten H, Granja C, Rylander C, Griffiths RD; RACHEL group. Intensive care diaries reduce new onset post traumatic stress disorder following critical illness: a randomised, controlled trial. Crit Care. 2010;14(5):R168. doi: 10.1186/cc9260. Epub 2010 Sep 15.

Reference Type BACKGROUND
PMID: 20843344 (View on PubMed)

Myhren H, Ekeberg O, Toien K, Karlsson S, Stokland O. Posttraumatic stress, anxiety and depression symptoms in patients during the first year post intensive care unit discharge. Crit Care. 2010;14(1):R14. doi: 10.1186/cc8870. Epub 2010 Feb 8.

Reference Type BACKGROUND
PMID: 20144193 (View on PubMed)

Jensen JF, Thomsen T, Overgaard D, Bestle MH, Christensen D, Egerod I. Erratum to: Impact of follow-up consultations for ICU survivors on post-ICU syndrome: a systematic review and meta-analysis. Intensive Care Med. 2015 Jul;41(7):1391. doi: 10.1007/s00134-015-3932-9. No abstract available.

Reference Type BACKGROUND
PMID: 26104120 (View on PubMed)

Davydow DS, Kohen R, Hough CL, Tracy JH, Zatzick D, Katon WJ. A pilot investigation of the association of genetic polymorphisms regulating corticotrophin-releasing hormone with posttraumatic stress and depressive symptoms in medical-surgical intensive care unit survivors. J Crit Care. 2014 Feb;29(1):101-6. doi: 10.1016/j.jcrc.2013.08.016. Epub 2013 Sep 24.

Reference Type BACKGROUND
PMID: 24075295 (View on PubMed)

Jones C, Backman C, Griffiths RD. Intensive care diaries and relatives' symptoms of posttraumatic stress disorder after critical illness: a pilot study. Am J Crit Care. 2012 May;21(3):172-6. doi: 10.4037/ajcc2012569.

Reference Type BACKGROUND
PMID: 22549573 (View on PubMed)

Knowles RE, Tarrier N. Evaluation of the effect of prospective patient diaries on emotional well-being in intensive care unit survivors: a randomized controlled trial. Crit Care Med. 2009 Jan;37(1):184-91. doi: 10.1097/CCM.0b013e31819287f7.

Reference Type BACKGROUND
PMID: 19050634 (View on PubMed)

Jones C, Griffiths RD, Humphris G, Skirrow PM. Memory, delusions, and the development of acute posttraumatic stress disorder-related symptoms after intensive care. Crit Care Med. 2001 Mar;29(3):573-80. doi: 10.1097/00003246-200103000-00019.

Reference Type BACKGROUND
PMID: 11373423 (View on PubMed)

Karnatovskaia LV, Johnson MM, Benzo RP, Gajic O. The spectrum of psychocognitive morbidity in the critically ill: a review of the literature and call for improvement. J Crit Care. 2015 Feb;30(1):130-7. doi: 10.1016/j.jcrc.2014.09.024. Epub 2014 Oct 2.

Reference Type BACKGROUND
PMID: 25449881 (View on PubMed)

Bergbom I, Svensson C, Berggren E, Kamsula M. Patients' and relatives' opinions and feelings about diaries kept by nurses in an intensive care unit: pilot study. Intensive Crit Care Nurs. 1999 Aug;15(4):185-91. doi: 10.1016/s0964-3397(99)80069-x.

Reference Type BACKGROUND
PMID: 10786503 (View on PubMed)

Ullman AJ, Aitken LM, Rattray J, Kenardy J, Le Brocque R, MacGillivray S, Hull AM. Diaries for recovery from critical illness. Cochrane Database Syst Rev. 2014 Dec 9;2014(12):CD010468. doi: 10.1002/14651858.CD010468.pub2.

Reference Type BACKGROUND
PMID: 25488158 (View on PubMed)

Garrouste-Orgeas M, Flahault C, Vinatier I, Rigaud JP, Thieulot-Rolin N, Mercier E, Rouget A, Grand H, Lesieur O, Tamion F, Hamidfar R, Renault A, Parmentier-Decrucq E, Monseau Y, Argaud L, Bretonniere C, Lautrette A, Badie J, Boulet E, Floccard B, Forceville X, Kipnis E, Soufir L, Valade S, Bige N, Gaffinel A, Hamzaoui O, Simon G, Thirion M, Bouadma L, Large A, Mira JP, Amdjar-Badidi N, Jourdain M, Jost PH, Maxime V, Santoli F, Ruckly S, Vioulac C, Leborgne MA, Bellalou L, Fasse L, Misset B, Bailly S, Timsit JF. Effect of an ICU Diary on Posttraumatic Stress Disorder Symptoms Among Patients Receiving Mechanical Ventilation: A Randomized Clinical Trial. JAMA. 2019 Jul 16;322(3):229-239. doi: 10.1001/jama.2019.9058.

Reference Type BACKGROUND
PMID: 31310299 (View on PubMed)

Sayde GE, Stefanescu A, Conrad E, Nielsen N, Hammer R. Implementing an intensive care unit (ICU) diary program at a large academic medical center: Results from a randomized control trial evaluating psychological morbidity associated with critical illness. Gen Hosp Psychiatry. 2020 Sep-Oct;66:96-102. doi: 10.1016/j.genhosppsych.2020.06.017. Epub 2020 Jul 2.

Reference Type DERIVED
PMID: 32763640 (View on PubMed)

Other Identifiers

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GH-17-022

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

ICU Diary RCT NOLA

Identifier Type: -

Identifier Source: org_study_id

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