Former patients believe that intensive care unit (ICU) follow-up services are important for their physical, emotional and psychological recovery. New research found that patients valued continuity of care after hospital discharge, information and reassurance from an expert familiar with their experience, and the opportunity to give feedback to ICU staff.
Suman Prinjha of the DIPEx Health Experiences Research Group, University of Oxford, interviewed patients about their ICU follow-up experiences. The work was supported by the Intensive Care National Audit and Research Centre (ICNARC). This study is unique because patients were gathered from many different ICUs. According to the authors, "We used a large sample size of patients from across the UK from different age groups, social and ethnic backgrounds, and reasons for ICU admission. The interviewer was also unconnected to the ICU service, making it easier for patients to speak openly about their experiences."
Discharge from ICU can be a very stressful time and patients often have difficulty coming to terms with their experience. The provision of ICU follow-up services in the UK is inconsistent; surveys estimate that only 30% of ICUs offer a follow-up clinic. In this study, patients without access to ICU follow-up services felt abandoned and unsupported during their recovery period, as they didn't have the opportunity to be monitored or referred quickly if they had any problems.
According to Suman, "This study highlights that patients value having ICU follow-up services but that their healthcare needs are often unmet because many hospitals do not provide this aftercare. Most patients were aware of the financial constraints on the health system and, while they valued ICU follow-up care, they did not want it to continue indefinitely, many of them declining appointment invitations when they themselves felt they no longer needed them."
Despite this, it remains uncertain whether ICU follow-up services change outcome and if they are cost effective in terms of clinical benefit. In the UK, as elsewhere, ICU follow-up care is relatively new and still evolving.
- Suman Prinjha, Kate Field and Kathy Rowan. What patients think about ICU follow-up services: a qualitative study. Critical Care, (in press)
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