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Young DL, Al-Ani A, Lakhmalla M, Raman V, Fatima A, Friedman LA, Challa SR, Vasishta S, Koneru M, Colantuoni E, Needham DM, Dinglas VD. Participant retention in follow-up studies of intensive care unit survivors - A scoping review. Aust Crit Care 2024:S1036-7314(24)00031-6. [PMID: 38582625 DOI: 10.1016/j.aucc.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/27/2023] [Accepted: 02/04/2024] [Indexed: 04/08/2024] Open
Abstract
OBJECTIVE To synthesize participant retention data and related reporting in studies evaluating post-hospital outcomes of survivors of critical illness after an intensive care unit (ICU) stay. REVIEW METHOD USED A synthesis of literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. DATA SOURCES PubMed, EMBASE, PsycINFO, Cumulative Index of Nursing and Allied Health Literature, and the Cochrane Controlled Trials Registry. Hand searched reference lists and personal files of relevant narrative and systematic review articles. REVIEW METHODS Articles were screened by pairs of independent reviewers. Similarly, data were abstracted by pairs of data collectors, with conflicts resolved by consensus or by a third reviewer. RESULTS We included 243 publications, from 225 unique studies of 87,602 participants. Participant retention could not be calculated for any time-points in 13% of studies nor in 22% of all follow-up time-points. Retention ranged from 18-100%. When compared to follow-up before 1-month, retention at each later timepoint was not significantly different. Age and sex were not associated with retention and more recent studies had decreased retention (odds ratio: 0.94 [95% confidence interval: 0.92-0.96; p < 0.001]). Reporting of retention-related study methodology was inconsistent. CONCLUSION Retention rate could not be calculated for 22% of study follow-up time-points, with retention at the remaining time-points generally being high (≥85%), but with high variability (18% - 100%). ICU survivorship research could be improved via: (i) more detailed guidance on reporting participant retention, and (ii) use of existing resources and best practices to facilitate better study design and to improve participant retention to preserve statistical power and reduce selection bias.
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Affiliation(s)
- Daniel L Young
- Department of Physical Therapy, University of Nevada, Las Vegas, Las Vegas, NV, USA; Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA; Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, USA
| | - Awsse Al-Ani
- Preventive Cardiology Department, Brigham and Women's Hospital, Boston, MA, USA
| | - Mounika Lakhmalla
- Department of Internal Medicine, Baton Rouge General Medical Center, Baton Rouge, LA, USA
| | - Vaishnavi Raman
- Division of Geriatric Medicine, Department of Medicine, Grand River Hospital and St. Mary's General Hospital, Kitchener, Ontario, Canada
| | - Arooj Fatima
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, USA
| | - Lisa Aronson Friedman
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, USA
| | | | - Sumana Vasishta
- NHS Wales Shared Service Partnership (NWSSP), Wales, United Kingdom
| | - Mounica Koneru
- Department of Pediatrics, The Brooklyn Hospital Center, Brooklyn, NY, USA
| | - Elizabeth Colantuoni
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Dale M Needham
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA; Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, USA; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, USA
| | - Victor D Dinglas
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, USA.
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Joseph B, Saljuqi AT, Phuong J, Shipper E, Braverman MA, Bixby PJ, Price MA, Barraco RD, Cooper Z, Jarman M, Lack W, Lueckel S, Pivalizza E, Bulger E. Developing a National Trauma Research Action Plan: Results from the geriatric research gap Delphi survey. J Trauma Acute Care Surg 2022; 93:209-219. [PMID: 35393380 DOI: 10.1097/ta.0000000000003626] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Treating older trauma patients requires a focus on the confluence of age-related physiological changes and the impact of the injury itself. Therefore, the primary way to improve the care of geriatric trauma patients is through the development of universal, systematic multidisciplinary research. To achieve this, the Coalition for National Trauma Research has developed the National Trauma Research Action Plan that has generated a comprehensive research agenda spanning the continuum of geriatric trauma care from prehospital to rehabilitation. METHODS Experts in geriatric trauma care and research were recruited to identify current gaps in clinical geriatric research, generate research questions, and establish the priority of these questions using a consensus-driven Delphi survey approach. Participants were identified using established Delphi recruitment guidelines ensuring heterogeneity and generalizability. On subsequent surveys, participants were asked to rank the priority of each research question on a nine-point Likert scale, categorized to represent low-, medium-, and high-priority items. The consensus was defined as more than 60% of panelists agreeing on the priority category. RESULTS A total of 24 subject matter experts generated questions in 109 key topic areas. After editing for duplication, 514 questions were included in the priority ranking. By round 3, 362 questions (70%) reached 60% consensus. Of these, 161 (44%) were high, 198 (55%) medium, and 3 (1%) low priority. CONCLUSION Among the questions prioritized as high priority, questions related to three types of injuries (i.e., rib fracture, traumatic brain injury, and lower extremity injury) occurred with the greatest frequency. Among the 25 highest priority questions, the key topics with the highest frequency were pain management, frailty, and anticoagulation-related interventions. The most common types of research proposed were interventional clinical trials and comparative effectiveness studies, outcome research, and health care systems research.
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Affiliation(s)
- Bellal Joseph
- From the Department of Surgery (B.J., A.T.S.), University of Arizona, College of Medicine, Tucson, Arizona; Department of Biomedical Informatics and Medical Education (J.P., E.S.), The University of Washington, Seattle, Washington; Coalition for National Trauma Research (M.A.B., P.J.B., M.A.P.), San Antonio, Texas; University of South Florida Morsani College of Medicine-Lehigh Valley Campus (R.D.B.), Allentown, Pennsylvania; Brigham & Women's Hospital (Z.C., M.J.), Boston, Massachusetts; Department of Surgery (W.L., E.B.), The Department of Surgery, Trauma and Surgical Critical Care Division (S.L.), Brown University, Providence, Rhode Island; Department of Anesthesiology (E.P.), UTHealth Houston McGovern Medical School, Houston, Texas; Department of Surgery, The Division of Trauma and Critical care (R.D.B.), Lehigh Valley Hospital and Health Network, University of South Florida Morsani College of Medicine (USF-MCOM), Lehigh Valley Campus, Allentown, PA
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Wake E, Brandenburg C, Heathcote K, Dale K, Campbell D, Cardona M. Follow-up of severely injured patients can be embedded in routine hospital care: results from a feasibility study. Hosp Pract (1995) 2022; 50:138-150. [PMID: 35297276 DOI: 10.1080/21548331.2022.2054633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Understanding the longitudinal patient experience outcomes following major trauma can promote successful recovery. A novel, hospital-led telephone follow-up program was implemented by a multi-disciplinary clinical trauma service team at a Level I trauma center. This process evaluation examined what factors promoted or impeded the program's implementation. METHODS A prospective convergent mixed methods process evaluation design was used. Quantitative data included patient and injury demographics and program feasibility data such number of telephone calls attempted/completed and call duration. Qualitative data consisted of semi-structured interviews with program participants (staff, patients, caregivers) who had participated in the program. Descriptive statistics and thematic analysis were applied to quantitative and qualitative data respectively. Data were collected concurrently and merged in the results to understand and describe the implementation and sustainability of the program. RESULTS 274 major trauma patients (ISS ≥ 12) were eligible for follow-up. A response rate of over 75% was achieved, with nurses responsible for most of the calls. Limited time and competing clinical demands were identified as barriers to the timely completion of the calls. Participants valued the pre-existing trauma service/patient relationship, and this facilitated program implementation. Clinicians were motivated to evaluate their patient's recovery, whilst patients felt 'cared for' and 'not forgotten' post-hospital discharge. Teamwork and leadership were highly valued by the clinical staff throughout the implementation period as ongoing source of motivation and support. Staff spontaneously developed the program to incorporate clinical follow up processes by providing guidance, advice and referrals to patients who indicated ongoing issues such as pain or emotional problems. CONCLUSION Telephone follow-up within a clinical trauma service team is feasible, accepted by staff and valued by patients and families. Despite time constraints, the successful implementation of this program is reliant on existing clinical/patient relationships, staff teamwork and leadership support.
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Affiliation(s)
- Elizabeth Wake
- Trauma Service, Gold Coast University Hospital, Queensland, Australia.,School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Queensland, Australia
| | - Caitlin Brandenburg
- Emergency Department, Gold Coast University Hospital, Queensland, Australia.,Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Kathy Heathcote
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Queensland, Australia
| | - Kate Dale
- Trauma Service, Gold Coast University Hospital, Queensland, Australia.,School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Queensland, Australia
| | - Don Campbell
- Trauma Service, Gold Coast University Hospital, Queensland, Australia.,School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Queensland, Australia
| | - Magnolia Cardona
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.,Evidence Based Practice Professorial Unit, Gold Coast Hospital and Health Service, Queensland, Australia.,Institute for Evidence Based Health, Bond University, Gold Coast, Queensland, Australia
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