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Protocol for a Hybrid Implementation-effectiveness Feasibility Study of a Transdisciplinary ICU-to-home Recovery Model (THRIVE@TTSH)

30. september 2026 opdateret af: Lau Yie Hui, Tan Tock Seng Hospital

Transition Support and Holistic Recovery Interventions for Vulnerable Ex-ICU Patients @ Tan Tock Seng Hospital (THRIVE@TTSH): Protocol for a Hybrid Implementation-effectiveness Feasibility Study of a Transdisciplinary ICU-to-home Recovery Model

This is a prospective, single-centre study which will recruit 50 adult ICU survivors over 12 months. Assessments will occur during hospitalisation and at Months 3 and 6 after hospital discharge, with a final phone follow-up at Month 12. There will be volunteer-supported home visits for 6 months post hospital discharge.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This is a prospective, single-centre hybrid implementation-effectiveness feasibility study which will recruit 50 adult ICU survivors over 12 months. Assessments will occur during hospitalisation and at Months 3 and 6 after hospital discharge, with a final phone follow-up at Month 12. There will be volunteer-supported home visits for 6 months post hospital discharge. The primary feasibility outcome is the proportion of enrolled participants alive at Month 6 who complete outcome assessment.

Secondary implementation outcomes include recruitment, retention, home-visit completion and acceptability. Exploratory outcomes include Post ICU Syndrome (PICS) recovery trajectories, healthcare utilisation and mortality through 12 months post discharge from the acute hospital.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

50

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

21 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion criteria

  1. Received invasive mechanical ventilation for ≥ 48 hours;
  2. Aged ≥ 21 years;
  3. Premorbidly independent in basic activities of daily living;
  4. Had decision-making capacity before the acute illness and are expected to regain capacity before acute hospital discharge;
  5. Have evidence of new or worsening physical, cognitive, mental-health or swallowing impairment compared with their premorbid state; and
  6. Are ultimately planned for discharge to the community/home setting. Worsening in PICS domains is defined as an increase in CFS score compared with premorbid status, newly acquired swallowing dysfunction, new cognitive impairment after exclusion of delirium, suspected anxiety or depressive symptoms, or clinically important deterioration in physical or functional performance.

Mental-health screening will not be interpreted as diagnostic criteria for anxiety or depressive disorders.

Exclusion criteria

  • cognitive or psychiatric impairment that precludes meaningful participation in the study;
  • are already enrolled in, or expected to enter, a structured follow-up pathway that substantially duplicates the rehabilitation intervention; or
  • have treatment primarily directed towards palliation or end-of-life care

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Sundhedstjenesteforskning
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Single arm feasibility study
  1. Structured post-ICU screening
  2. Comprehensive multidomain assessment
  3. Personalised ICU recovery summary
  4. Multidisciplinary review and closed-loop care coordination
  5. Volunteer-supported home follow-up and multidisciplinary meetings

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
completion of the Month-6 PICS physical assessment
Tidsramme: From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment

Physical :5 Times Sit-to-Stand Time in seconds required to complete five sit-to-stand repetitions. Values will be summarized at each assessment time point and change over time described.

From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment
completion of the Month 6 physical domain assessment
Tidsramme: From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment

Handgrip strength measured in kilograms using a standardized dynamometer procedure. Values will be summarized at each assessment time point and longitudinal change described.

From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment
completion of Month 6 Cognitive domain assessment
Tidsramme: From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment Time points: (Hospital discharge, 3, 6 month post hospital discharge)

Cognitive function measured using the Mini Mental State examination. Scores will be summarized at each assessment time point and longitudinal change described. MoCA may be used where clinically indicated and will be reported separately rather than treated as equivalent to MMSE.

From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment Time points: (Hospital discharge, 3, 6 month post hospital discharge)
Completion of Month 6 Mental Domain assessment
Tidsramme: From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment

Depressive symptoms screened using the Patient Health Questionnaire-9(PHQ-9). Total scores will be summarized at each assessment time point

From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment
Completion of Month 6 Mental Domain Assessment
Tidsramme: From recruitment to 6 months post hospital discharge, or death by any cause, up toFrom recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment

Anxiety symptoms screened using the GAD-7. Total scores will be summarized at each assessment time point

From recruitment to 6 months post hospital discharge, or death by any cause, up toFrom recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment
Health related quality of life
Tidsramme: from recruitment to 12 months post hospital discharge, or date of death from any cause (time points: 3,6 and 12 months post hospital discharge), up to 24 months from recruitment

Health-related quality of life assessed using the EQ-5D-5L. EQ-5D-5L health-state/index values and EQ visual analogue scale scores will be summarized as applicable at each assessment time point.

from recruitment to 12 months post hospital discharge, or date of death from any cause (time points: 3,6 and 12 months post hospital discharge), up to 24 months from recruitment
Modified Barthel Index
Tidsramme: From recruitment to 12 months post hospital discharge, or death by any cause up to 24 months from recruitment

Functional independence measured using the Modified Barthel Index. Higher scores indicate greater independence in activities of daily living. Scores will be summarized at each assessment time point

From recruitment to 12 months post hospital discharge, or death by any cause up to 24 months from recruitment
Return to work status
Tidsramme: From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment

Employment status prior to ICU admission and post hospital discharge will be assessed. Among participants employed before critical illness, the number and percentage who have returned to work will be reported.

From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Feasibility of program
Tidsramme: From start of screening to 12 months post hospital discharge for the last patient recruited (approximately 24 months from start of study)

proportion of eligible patients successfully recruited out (screened at ICU discharge)

From start of screening to 12 months post hospital discharge for the last patient recruited (approximately 24 months from start of study)
Five Times Sit to Stand
Tidsramme: From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment (time points :at hospital discharge, 3 and 6 months post hospital discharge

Time in seconds required to complete five sit-to-stand repetitions. Values will be summarized at each assessment time point and change over time described.

From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment (time points :at hospital discharge, 3 and 6 months post hospital discharge
Grip strength
Tidsramme: From recruitment to 6 months post hospital discharge or date of death from any cause, up to 24 months from recruitment (Time points: ICU discharge, hospital discharge, 3 and 6 months post hospital discharge)

Handgrip strength with dynamometer

From recruitment to 6 months post hospital discharge or date of death from any cause, up to 24 months from recruitment (Time points: ICU discharge, hospital discharge, 3 and 6 months post hospital discharge)
Modified Barthel Index
Tidsramme: From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment (Time points: hospital discharge, 3,6, 12 month post hospital discharge

Functional independence measured using the Modified Barthel Index. Higher scores indicate greater independence in activities of daily living. Scores will be summarized at each assessment time point and longitudinal change described.

From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment (Time points: hospital discharge, 3,6, 12 month post hospital discharge
Mini-mental state examination
Tidsramme: From recruitment to 6 months post hospital discharge, up to 24 months from recruitment Time points: (Hospital discharge, 3, 6 month post hospital discharge)

Cognitive function measured using the MMSE. Scores will be summarized at each assessment time point and longitudinal change described. MoCA may be used where clinically indicated and will be reported separately rather than treated as equivalent to MMSE.

From recruitment to 6 months post hospital discharge, up to 24 months from recruitment Time points: (Hospital discharge, 3, 6 month post hospital discharge)
Patient health questionnaire -9
Tidsramme: From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment (Time points :Hospital discharge, 3, 6 month post hospital discharge)

Depressive symptoms measured using the PHQ-9. Total scores will be summarized at each assessment time point and longitudinal change described.

From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment (Time points :Hospital discharge, 3, 6 month post hospital discharge)
General anxiety scale-7
Tidsramme: From recruitment up to 24 months from recruitment (time points: hospital discharge, 3,6 month post hospital discharge)

Anxiety symptoms measured using the GAD-7. Total scores will be summarized at each assessment time point and longitudinal change described.

From recruitment up to 24 months from recruitment (time points: hospital discharge, 3,6 month post hospital discharge)
Retention at 6 months
Tidsramme: From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment

Number of ICU survivors who have not withdrawn/ lost to follow up compared to original recruited number (excluding deaths)

From recruitment to 6 months post hospital discharge, or death by any cause, up to 24 months from recruitment
Completion of planned home visits
Tidsramme: 6 months post hospital discharge, up to 24 months from recruitment

Monthly home visits x6 are planned per ICU survivor Number of planned home visits declined/ lost to follow up amongst survivors (excluding deaths) 3 and 6 month home visits converted to telehealth/ hospital visits

6 months post hospital discharge, up to 24 months from recruitment
UCLA loneliness scale-3
Tidsramme: from recruitment up to 24 months post recruitment (time points 1,4 12 months post hospital discharge)

University of California Los Angeles loneliness scale-3

from recruitment up to 24 months post recruitment (time points 1,4 12 months post hospital discharge)
Caregiver burden
Tidsramme: From recruitment to 6 months post hospital discharge, or patient death by any cause , up to 24 hours post recruitment (Time points :1 and 6 months post hospital discharge)

Caregiver burden will be measured using the shortened 9-item Zarit Burden Interview (ZBI-9), with scores summarized over follow-up.

From recruitment to 6 months post hospital discharge, or patient death by any cause , up to 24 hours post recruitment (Time points :1 and 6 months post hospital discharge)
reasons for non-participation or declining home visits
Tidsramme: at the point of enrolment into home visits at hospital discharge up to 6 months post hospital discharge, or death from any cause, whichever comes first , up to 24 months from recruitment

reasons for non-participation of home visits

at the point of enrolment into home visits at hospital discharge up to 6 months post hospital discharge, or death from any cause, whichever comes first , up to 24 months from recruitment
Medication or follow-up appointment reconciliation events
Tidsramme: 6 months post hospital discharge, from recruitment up to 24 months from recruitment

number of medication or follow up appointment reconciliation events done during home visits, per home visit

6 months post hospital discharge, from recruitment up to 24 months from recruitment
Swallowing status
Tidsramme: From recruitment into study, up 24 months from recruitment, or death by any cause, whichever first (time points: at the Icu discharge, hospital discharge, 2 and 5 months post hospital discharge

In- hospital, oral intake and swallowing status assessed using the Functional Oral Intake Scale. EAT-10 questionnaire post hospital discharge; Scores will be summarized descriptively over follow-up.

From recruitment into study, up 24 months from recruitment, or death by any cause, whichever first (time points: at the Icu discharge, hospital discharge, 2 and 5 months post hospital discharge
Body weight
Tidsramme: From recruitment into study, up to 24 months from recruitment, or death from any cause, whichever comes first (time points: pre ICU, at the Icu discharge, hospital discharge, 2 and 5 months post hospital discharge

Contributes to nutritional assessment Body weight measured in kilograms and summarized at each assessment time point and longitudinally.

From recruitment into study, up to 24 months from recruitment, or death from any cause, whichever comes first (time points: pre ICU, at the Icu discharge, hospital discharge, 2 and 5 months post hospital discharge
arm and leg circumference
Tidsramme: From recruitment into study, up to 24months from recruitment or death from any cause, whichever comes first (Time points: at the Icu discharge, hospital discharge, 2 and 5 months post hospital discharge)

arm and leg circumference as a surrogate for nutritional status and muscle bulk.

Excludes patients who have contraindications e.g. loss of limb, abnormal BMI, edema

From recruitment into study, up to 24months from recruitment or death from any cause, whichever comes first (Time points: at the Icu discharge, hospital discharge, 2 and 5 months post hospital discharge)
Chelsea Critical Care Physical Assessment tool
Tidsramme: From recruitment into study, up to death from any cause or 24 months from recruitment, whichever comes first.

CPax

From recruitment into study, up to death from any cause or 24 months from recruitment, whichever comes first.
Montreal Cognitive Assessment Tool
Tidsramme: From recruitment into study, 6 months post hospital discharge, or date of death from any cause, whichever comes first (if applicable)

MoCA assessment for patients screened with MMSE and have high suspicion of cognitive impairment

From recruitment into study, 6 months post hospital discharge, or date of death from any cause, whichever comes first (if applicable)
healthcare utilisation
Tidsramme: 12 months post hospital discharge

number of unplanned clinic visits, emergency department visits, unplanned admissions with reference from point of hospital discharge

12 months post hospital discharge
mortality
Tidsramme: From recruitment to 12 months post hospital discharge, up till 24 months from recruitment, or death by any cause, whichever comes first

mortality

From recruitment to 12 months post hospital discharge, up till 24 months from recruitment, or death by any cause, whichever comes first
return to work status
Tidsramme: From recruitment until 24 months from recruitment (time points: 3,6 12 months post hospital discharge)

for survivors who were working pre ICU admission, the number who returned to work

From recruitment until 24 months from recruitment (time points: 3,6 12 months post hospital discharge)

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
life-space
Tidsramme: From recruitment to 24 months from recruitment, or death from any cause, whichever comes first (Time points: Pre ICU admission, 3,6 and 12 months)

Life space at month 3, 6, 12 post hospital discharge

From recruitment to 24 months from recruitment, or death from any cause, whichever comes first (Time points: Pre ICU admission, 3,6 and 12 months)
Clinical Frailty Scale
Tidsramme: From hospital admission up to 24 months from recruitment (Time points: pre-ICU baseline , hospital discharge, 3, 6, 12 months post hospital)

trajectory of CFS over time. Scores will be summarized descriptively across assessment time points.

From hospital admission up to 24 months from recruitment (Time points: pre-ICU baseline , hospital discharge, 3, 6, 12 months post hospital)
User acceptability
Tidsramme: From recruitment up till 24 months from recruitment or date of death from any cause (Time points: 6 and 12 month post hospital discharge )

acceptability of the program and free text comments

From recruitment up till 24 months from recruitment or date of death from any cause (Time points: 6 and 12 month post hospital discharge )

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: Yie Hui Lau, Tan Tock Seng Hospital

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

31. oktober 2026

Primær færdiggørelse (Anslået)

30. juni 2028

Studieafslutning (Anslået)

31. december 2028

Datoer for studieregistrering

Først indsendt

21. september 2026

Først indsendt, der opfyldte QC-kriterier

30. september 2026

Først opslået (Faktiske)

2. oktober 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

2. oktober 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

30. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • NTF_FY25_T1C1_17

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