The effects of intensive care unit-initiated transitional care interventions on elements of post-intensive care syndrome: A systematic review and meta-analysis

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Hoog, Sabine Adriana Johanna Josepha op't
Eskes, Anne Maria
van Mersbergen-de Bruin, Marielle Pieternella Johanna
Pelgrim, Thomas
van der Hoeven, Hans
Vermeulen, Hester
Vloet, Lilian Christina Maria
Griffith University Author(s)
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2022
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Abstract

Objective The aim of the study was to assess the effectiveness of intensive care unit (ICU)–initiated transitional care interventions for patients and families on elements of post-intensive care syndrome (PICS) and/or PICS-family (PICS–-F).

Review method used This is a systematic review and meta-analysis

Sources The authors searched in biomedical bibliographic databases including PubMed, Embase (OVID), CINAHL Plus (EBSCO), Web of Science, and the Cochrane Library and included studies written in English conducted up to October 8, 2020.

Review methods We included (non)randomised controlled trials focussing on ICU-initiated transitional care interventions for patients and families. Two authors conducted selection, quality assessment, and data extraction and synthesis independently. Outcomes were described using the three elements of PICS, which were categorised into (i) physical impairments (pulmonary, neuromuscular, and physical function), (ii) cognitive impairments (executive function, memory, attention, visuo-spatial and mental processing speed), and (iii) psychological health (anxiety, depression, acute stress disorder, post-traumatic stress disorder, and depression).

Results From the initially identified 5052 articles, five studies were included (i.e., two randomised controlled trials and three nonrandomised controlled trials) with varied transitional care interventions. Quality among the studies differs from moderate to high risk of bias. Evidence from the studies shows no significant differences in favour of transitional care interventions on physical or psychological aspects of PICS-(F). One study with a nurse-led structured follow-up program showed a significant difference in physical function at 3 months.

Conclusions Our review revealed that there is a paucity of research about the effectiveness of transitional care interventions for ICU patients with PICS. All, except one of the identified studies, failed to show a significant effect on the elements of PICS. However, these results should be interpreted with caution owing to variety and scarcity of data.

Prospero registration CRD42020136589 (available via https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020136589).

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Australian Critical Care

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35

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3

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© 2021 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Intensive care

Nursing

Science & Technology

Life Sciences & Biomedicine

Critical Care Medicine

Nursing

General & Internal Medicine

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Hoog, SAJJO; Eskes, AM; van Mersbergen-de Bruin, MPJ; Pelgrim, T; van der Hoeven, H; Vermeulen, H; Vloet, LCM, The effects of intensive care unit-initiated transitional care interventions on elements of post-intensive care syndrome: A systematic review and meta-analysis, Australian Critical Care, 2022, 35 (3), pp. 309-320

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