Lai, Daniel Jie, Liu, Zhao, Johnston, Elaine, Dikomitis, Lisa, D’Oliveira, Teresa C., Shergill, Sukhi S. (2024) Exploring the effectiveness of eHealth interventions in treating Post Intensive Care Syndrome (PICS) outcomes: a systematic review. Critical Care, 28 (1). Article Number 317. ISSN 1364-8535. E-ISSN 1466-609X. (doi:10.1186/s13054-024-05089-6) (Access to this publication is currently restricted. You may be able to access a copy if URLs are provided) (KAR id:107391)
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Official URL: https://doi.org/10.1186/s13054-024-05089-6 |
Abstract
Background
It remains unclear how to optimise critical care rehabilitation to reduce the constellation of long-term physical, psychological and cognitive impairments known as Post Intensive Care Syndrome (PICS). Possible reasons for poor recovery include access to care and delayed treatment. eHealth could potentially aid in increasing access and providing consistent care remotely. Our review aimed to evaluate the effectiveness of eHealth interventions on PICS outcomes.
Methods
Studies reporting eHealth interventions targeting Post Intensive Care Syndrome outcomes, published in Medline, CINAHL, PsycINFO, Embase, and Scopus from 30th January 2010 to 12th February 2024, were included in the review. Study eligibility was assessed by two reviewers with any disagreements discussed between them or resolved by a third reviewer. Study quality and risk of bias were assessed using the Mixed Method Appraisal Tool. Further to the identification of effective strategies, our review also aimed to clarify the timeline of recovery considered and the outcomes or domains targeted by the interventions.
Results
Thirteen studies were included in our review. Study duration, eHealth intervention delivery format, and outcome measures varied considerably. No studies reported a theory of behavioural change and only one study was co-produced with patients or carers. Most studies were conducted in the early post-discharge phase (i.e., < 3 months) and had feasibility as a primary outcome. The cognitive domain was the least targeted and no intervention targeted all three domains. Interventions targeting the psychological domain suggest generally positive effects. However, results were underpowered and preliminary. Though all studies were concluded to be feasible, most studies did not assess acceptability. In studies that did assess acceptability, the main facilitators of acceptability were usability and perceived usefulness, and the main barrier was sensitivity to mental health and cognitive issues.
Conclusion
Our systematic review highlighted the promising contributions of eHealth with preliminary support for the feasibility of interventions in the early stages of post-critical care rehabilitation. Future research should focus on demonstrating effectiveness, acceptability, the cognitive domain, and multi-component interventions.
Item Type: | Article |
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DOI/Identification number: | 10.1186/s13054-024-05089-6 |
Additional information: | For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. |
Uncontrolled keywords: | critical care; critical Illness; critical care rehabilitation; post-intensive care syndrome; EHealth, digital health technologies |
Subjects: | R Medicine |
Divisions: | Divisions > Division of Natural Sciences > Kent and Medway Medical School |
Funders: |
NIHR Wellcome Trust Southampton Clinical Research Facility (https://ror.org/046xy0k58)
NIHR Maudsley Biomedical Research Centre (https://ror.org/05fd9ct06) South London and Maudsley NHS Foundation Trust (https://ror.org/015803449) |
Depositing User: | Manfred Gschwandtner |
Date Deposited: | 30 Sep 2024 15:56 UTC |
Last Modified: | 05 Nov 2024 13:13 UTC |
Resource URI: | https://kar.kent.ac.uk/id/eprint/107391 (The current URI for this page, for reference purposes) |
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