Effects of The Caregiver Pathway intervention on symptoms of post-intensive care syndrome among family caregivers to critically ill patients: long-term results from a randomized controlled trial

Abstract

Purpose: A long-term evaluation of The Caregiver Pathway, a model to follow up family caregivers on Post-intensive Care Symptoms among Family (PICS-F). Methods: A single-center non-blinded randomized controlled trial including 196 family caregivers to critically ill patients randomized to intervention (n = 101) or control group (n = 95). The Caregiver Pathway intervention consists of: (1) a digital assessment followed by a conversation with a nurse in the first days at the ICU, (2) a supportive card when leaving the ICU, (3) an offer to receive a phone call following patient transfer to a step-down unit, and (4) a follow-up conversation within 3 months after discharge. Outcome measures were collected at 6 and 12 months, including symptoms of post-traumatic stress disorder (PTSD), anxiety, depression, Health-related Quality of Life (HRQoL), hope, and self-efficacy. Results: The Caregiver Pathway was associated with a significant effect for symptoms of PTSD after 6 months compared with controls, mean IES-R score: 25.8 [95% CI 21.9–29.7] versus 30.9 [95% CI 26.7–35.0], p = 0.009, and a trend toward an effect after 12 months: IES-R score: 25.0 [95% CI 21.3–28.7] versus 28.4 [95% CI 24.1–32.7], p = 0.057. Subgroup analyses at 12 months showed a significant intervention effect among family caregivers of patients who survived compared to controls for PTSD, IES-R score: 19.8 [95% CI 15.3–24.2] versus 29.1 [95% CI 23.5–34.6], p = 0.001, and anxiety, HADS-A score: 4.3 [95% CI 3.1–5.4] versus 6.8 [95% CI 5.2–8.4], p = 0.003. Conclusions: The Caregiver Pathway has the potential to reduce the symptoms of PICS-F, especially among family caregivers whose patient has survived.