Survivors of Acute Respiratory Failure (ARF) suffer from long-term morbidity in the form of functional disability, cognitive impairment, major or minor depression, and anxiety. These complications negatively impact the quality of life of these ARF survivors, interfere with their recovery, lead to long-term disability, and cost the health care system $3.5 million per ARF survivor. These sequelae and attendant morbidity have now been designated as the post-intensive care syndrome (PICS). Although there are community resources and rehabilitation services, but due to a fragmented healthcare delivery process, a meaningful recovery is unattainable. Indiana University Center for Aging Research (IUCAR) has over 20 years of experience to provide interdisciplinary, collaborative care utilizing care coordinators integrated with primary care and other specialties. These care models have improved care of elderly with chronic disease states such as dementia, depression, and functional impairment by overcoming fragmented care through care coordination. The current proposal termed the Mobile Critical Care Recovery Program (m-CCRP) for Acute Respiratory Failure (ARF) Survivors builds from the IUCAR's experience of delivering collaborative care. The m-CCRP aims to improve the recovery of ARF survivors through a randomized controlled trial utilizing a mobile care coordinator. The trial has the following specific aims: 1) Evaluate the efficacy of m-CCRP in improving the health related quality of life of ARF survivors. 2) Evaluate the efficacy of m-CCRP in improving the cognitive, physical, and psychological function of ARF survivors. 3) Evaluate the efficacy of m-CCRP in reducing the health-care utilization by ARF survivors. This research is innovative as it promotes a novel interdisciplinary intervention among ARF survivors with continuous feedback and rapid adaptability. The outcomes of this trial will be significant and foundational for dissemination/ implementation of the program across the US health care system to achieve the aims of better health, better care, and reduced health care utilization as promoted by the Institute of Healthcare.

Public Health Relevance

Two million Americans require admission to intensive care units (ICU) annually due to acute respiratory failure (ARF) that predisposes them to long-term morbidity in the form of functional, cognitive, and psychological impairments; now termed as post-intensive care syndrome (PICS). Interventions to reduce the burden of PICS among ARF survivors can lead to an improved quality of life and a decrease in health care utilization by ARF survivors. This proposal aims to conduct a randomized controlled trial to evaluate the efficacy of a novel mobile Critical Care Recovery Program (m-CCRP) in improving the quality of life of ARF survivors.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
Project #
Application #
Study Section
Nursing and Related Clinical Sciences Study Section (NRCS)
Program Officer
Reineck, Lora A
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Indiana University-Purdue University at Indianapolis
Internal Medicine/Medicine
Schools of Medicine
United States
Zip Code
Khan, Sikandar; Biju, Ashok; Wang, Sophia et al. (2018) Mobile critical care recovery program (m-CCRP) for acute respiratory failure survivors: study protocol for a randomized controlled trial. Trials 19:94
Wang, Sophia; Allen, Duane; Kheir, You Na et al. (2018) Aging and Post-Intensive Care Syndrome: A Critical Need for Geriatric Psychiatry. Am J Geriatr Psychiatry 26:212-221
Wang, Sophia; Hammes, Jessica; Khan, Sikandar et al. (2018) Improving Recovery and Outcomes Every Day after the ICU (IMPROVE): study protocol for a randomized controlled trial. Trials 19:196
Khan, Babar A; Alder, Catherine A; Boustani, Malaz A (2017) Finding the Distribution Channels for Effective Transitional Care Services. J Am Geriatr Soc 65:1392-1393
Khan, Babar A (2017) The author replies. Crit Care Med 45:e1193
Wang, Sophia; Mosher, Chris; Perkins, Anthony J et al. (2017) Post-Intensive Care Unit Psychiatric Comorbidity and Quality of Life. J Hosp Med 12:831-835
Khan, Babar A; Perkins, Anthony J; Gao, Sujuan et al. (2017) The Confusion Assessment Method for the ICU-7 Delirium Severity Scale: A Novel Delirium Severity Instrument for Use in the ICU. Crit Care Med 45:851-857