Palliative care · Supporting families
A Randomized Trial of a Family-Support Intervention in Intensive Care Units
| Design | Stepped-wedge cluster-randomised trial |
|---|---|
| Treatment | Family-support intervention delivered by the interprofessional ICU team |
| Control | Usual care |
| Population | 1420 critically ill patients and their surrogate decision makers |
| Follow-up | 6 months |
| Primary endpoint | Surrogates' Hospital Anxiety and Depression Scale score at 6 months |
| Result | There was no significant difference between intervention and control in surrogates' mean HADS score at 6 months. The intervention improved surrogates' ratings of the quality of communication and patient- and family-centredness of care, and shortened ICU length of stay. |
| Secondary endpoints | Quality of communication, patient- and family-centredness of care, ICU length of stay, mortality |
Among critically ill patients and their surrogates, a family-support intervention delivered by the interprofessional ICU team did not significantly affect the surrogates' burden of psychological symptoms, but the surrogates' ratings of the quality of communication and the patient- and family-centeredness of care were better and the length of the ICU stay was shorter with the intervention than with usual care.
The trial authors, in the published abstract
Better communication did not reduce anxiety and depression six months on, which is a sobering finding for an intervention designed around exactly that. The shorter ICU stay is the concrete result, and it came from families reaching decisions sooner.
White DB, Angus DC, Shields AM, et al. A Randomized Trial of a Family-Support Intervention in Intensive Care Units. N Engl J Med 2018 Jun 21;378(25):2365-2375.