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

keskiviikko 30. syyskuuta 2026 päivittänyt: 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.

Tutkimuksen yleiskatsaus

Tila

Ei vielä rekrytointia

Ehdot

Interventio / Hoito

Yksityiskohtainen kuvaus

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.

Opintotyyppi

Interventio

Ilmoittautuminen (Arvioitu)

50

Vaihe

  • Ei sovellettavissa

Yhteystiedot ja paikat

Tässä osiossa on tutkimuksen suorittajien yhteystiedot ja tiedot siitä, missä tämä tutkimus suoritetaan.

Opiskeluyhteys

Osallistumiskriteerit

Tutkijat etsivät ihmisiä, jotka sopivat tiettyyn kuvaukseen, jota kutsutaan kelpoisuuskriteereiksi. Joitakin esimerkkejä näistä kriteereistä ovat henkilön yleinen terveydentila tai aiemmat hoidot.

Kelpoisuusvaatimukset

Opintokelpoiset iät

21 vuotta ja vanhemmat (Aikuinen, Vanhempi Aikuinen)

Hyväksyy terveitä vapaaehtoisia

Ei

Sukupuolet, jotka voivat opiskella

Kaikki

Kuvaus

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

Opintosuunnitelma

Tässä osiossa on tietoja tutkimussuunnitelmasta, mukaan lukien kuinka tutkimus on suunniteltu ja mitä tutkimuksella mitataan.

Miten tutkimus on suunniteltu?

Suunnittelun yksityiskohdat

  • Ensisijainen käyttötarkoitus: Terveyspalvelututkimus
  • Jako: Ei käytössä
  • Inventiomalli: Yksittäinen ryhmätehtävä
  • Naamiointi: Ei mitään (avoin tarra)

Aseet ja interventiot

Osallistujaryhmä / Arm
Interventio / Hoito
Kokeellinen: 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

Mitä tutkimuksessa mitataan?

Ensisijaiset tulostoimenpiteet

Tulosmittaus
Toimenpiteen kuvaus
Aikaikkuna
completion of the Month-6 PICS physical assessment
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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

Toissijaiset tulostoimenpiteet

Tulosmittaus
Toimenpiteen kuvaus
Aikaikkuna
Feasibility of program
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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)

Muut tulostoimenpiteet

Tulosmittaus
Toimenpiteen kuvaus
Aikaikkuna
life-space
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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 )

Yhteistyökumppanit ja tutkijat

Täältä löydät tähän tutkimukseen osallistuvat ihmiset ja organisaatiot.

Sponsori

Tutkijat

  • Päätutkija: Yie Hui Lau, Tan Tock Seng Hospital

Opintojen ennätyspäivät

Nämä päivämäärät seuraavat ClinicalTrials.gov-sivustolle lähetettyjen tutkimustietueiden ja yhteenvetojen edistymistä. National Library of Medicine (NLM) tarkistaa tutkimustiedot ja raportoidut tulokset varmistaakseen, että ne täyttävät tietyt laadunvalvontastandardit, ennen kuin ne julkaistaan ​​julkisella verkkosivustolla.

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