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.
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.
