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ICU Intervention Doesn't Impact Surrogate Psychological Burden

WEDNESDAY, May 23, 2018 -- A family-support intervention delivered by the interprofessional intensive care unit (ICU) team does not significantly impact surrogates' burden of psychological symptoms, according to a study published online May 23 in the New England Journal of Medicine to coincide with the American Thoracic Society's 2018 International Conference, held from May 18 to 23 in San Diego.

Douglas B. White, M.D., from the University of Pittsburgh School of Medicine, and colleagues conducted a trial involving patients with a high risk of death and their surrogate decision makers in five ICUs to compare a multicomponent family-support intervention delivered by the interprofessional ICU team with usual care. A total of 1,420 patients were enrolled in the trial.

The researchers found that the intervention and control groups did not differ significantly in terms of the surrogates' mean Hospital Anxiety and Depression Scale (HADS) score at six months (11.7 versus 12.0) or in the mean Impact of Event Scale score (21.2 versus 20.3). Compared with the control group, the intervention group had a significantly better surrogate mean Quality of Communication scale score (69.1 versus 62.7), and mean modified Patient Perception of Patient Centeredness scale score (1.7 versus 1.8).

"Our data are not directive, but they suggest that equipoise is present and that a large replication trial may be conducted in multiple geographic regions to establish the generalizability of the findings," the authors write.

One author disclosed financial ties to Eli Lilly.

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Posted: May 2018