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Trial registered on ANZCTR
Registration number
ACTRN12624000267550
Ethics application status
Approved
Date submitted
2/02/2024
Date registered
15/03/2024
Date last updated
30/08/2024
Date data sharing statement initially provided
15/03/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of a Digital Peer Support Intervention for ICU Survivors on Health Related Quality of Life: icuRESOLVE (icu Recovery Solutions Co-Designed through SurVivor Engagement) Randomised Controlled Trial
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Scientific title
Effect of a Digital Peer Support Intervention for ICU Survivors on Health-Related Quality of Life: icuRESOLVE (icu Recovery Solutions Co-Designed through SurVivor Engagement) Randomised Controlled Trial
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Secondary ID [1]
311461
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None
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Universal Trial Number (UTN)
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Trial acronym
icuRESOLVE
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Critical illness
332762
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Post Intensive Care Syndrome
332763
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Condition category
Condition code
Mental Health
329481
329481
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0
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Other mental health disorders
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Physical Medicine / Rehabilitation
329482
329482
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0
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Other physical medicine / rehabilitation
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Public Health
329483
329483
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0
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Health service research
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intervention group (peer support + recovery booklet):
Additional to standard care (Intervention) summarized here:
What? Digital, facilitated peer support group. Two components:
1) Educational/informational exchange delivered by staff on common problems faced after ICU
2) Group/peer to peer discussion of shared experiences and pragmatic solutions
The formal component is education delivered by expert clinicians, at the participant pace with time for questions from participants. This education is delivered via powerpoint using the Zoom screen-share function. The informal component includes facilitated peer-to-peer discussion to share experiences and support social cohesion, led by a social worker or psychologist skilled in-group facilitation.
When? 1x fortnight, starting at 6-8 weeks post-hospital discharge
Where? Online, via Zoom platform
For how long? 1-hour session total (30 minutes formal introduction + 30 minutes facilitated peer support), for a total of 4 topics, fortnightly across 8 weeks.
The digital peer support program will be an ongoing ‘rolling’ program, with sessions held every 2 weeks - so participants will enter program at one topic, and keep attending until all four topics completed, then exit program.
Participants will also be provided with an education booklet, which was co-designed and has undergone extensive consumer engagement. The consumer engagement process included stakeholder input from ICU patients, ICU caregivers, ICU clinicians and researchers to develop the comprehensive booklet to support the recovery process. The content was developed by expert clinician presenters and the project team, and then sent to patient and caregivers for feedback using an iterative process, over a fortnight. The initial experienced based co-design methodology used to develop the peer support program occurred using stakeholder consumer input over three 2 hour workshops over a one month period, the information generated through this process was incorporated into this document. The feedback sought during the pilot trial from participants was also included in the development process for this booklet. The booklet contains patient and carer focused information that explains some of the potential impacts of critical illness on their health (e.g. post-intensive care syndrome), and where to seek support following hospital discharge, has a section on goal-setting and useful information that can be shared with their general practitioner.
Intervention adherence for this group will be monitored with an attendance log, completed by peer support facilitators each session.
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Intervention code [1]
327909
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Treatment: Other
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Comparator / control treatment
Standard care: Patients currently do not receive any formal specialised ICU follow-up care post-hospital discharge, nor specialised recovery-based information. Standard care does involve referral to various community service providers at the discretion of community care providers, for example referral to outpatient physiotherapy or psychology from the patient's general practitioner.
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Control group
Active
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Outcomes
Primary outcome [1]
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Health-related quality of life
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Assessment method [1]
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EQ-5D-5L visual analogue scale
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Timepoint [1]
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Baseline: 4-8 weeks post-hospital discharge
Two follow-up time points of 14-18 weeks and 26-28 weeks post-hospital discharge
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Secondary outcome [1]
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Self-reported health status
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Assessment method [1]
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EQ-5D-5L visual analogue scale
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Timepoint [1]
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Baseline: 4-8 weeks post-hospital discharge
Two follow-up time points of 14-18 weeks and 26-28 weeks post-hospital discharge
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Secondary outcome [2]
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Post-traumatic stress disorder
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Assessment method [2]
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Impact of Events Scale Revised (IES-R)
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Timepoint [2]
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Baseline: 4-8 weeks post-hospital discharge
Two follow-up time points of 14-18 weeks and 26-28 weeks post-hospital discharge
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Secondary outcome [3]
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Social Isolation
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Assessment method [3]
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UCLA Loneliness scale (3 item)
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Timepoint [3]
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Baseline: 4-8 weeks post-hospital discharge
Two follow-up time points of 14-18 weeks and 26-28 weeks post-hospital discharge
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Secondary outcome [4]
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Resilience
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Assessment method [4]
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Connor Davidson Resilience Scale (CD-RISC)
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Timepoint [4]
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Baseline: 4-8 weeks post-hospital discharge
Two follow-up time points of 14-18 weeks and 26-28 weeks post-hospital discharge
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Secondary outcome [5]
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Quality of Life
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Assessment method [5]
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Assessment of Quality of Life 6-item scale
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Timepoint [5]
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Baseline: 4-8 weeks post-hospital discharge
Two follow-up time points of 14-18 weeks and 26-28 weeks post-hospital discharge
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Secondary outcome [6]
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Patient activation
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Assessment method [6]
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Patient Activation Measure (13 item)
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Timepoint [6]
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Secondary outcome [7]
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Patient activation
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Assessment method [7]
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Patient Activation Measure (13 item)
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Timepoint [7]
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Baseline: 4-8 weeks post-hospital discharge Two follow-up time points of 14-18 weeks and 26-28 weeks post-hospital discharge
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Secondary outcome [8]
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Intervention Adherence (Intervention group only)
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Assessment method [8]
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Intervention Adherence Survey (investigator devised 10-item survey)(Intervention group only)
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Timepoint [8]
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Baseline: 4-8 weeks post-hospital discharge Two follow-up time points of 14-18 weeks and 26-28 weeks post-hospital discharge
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Secondary outcome [9]
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Intervention Adherence (Intervention group only)
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Assessment method [9]
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Intervention Adherence Survey (investigator devised 10-item survey)(Intervention group only)
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Timepoint [9]
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At conclusion of final intervention session (intervention group only)
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Eligibility
Key inclusion criteria
• ICU admission >48 hours at participating hospital
• Age 18 years and over
• Access to digital platform (functioning computer, internet access and speed, capacity to log onto a video-sharing platform)
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
• Death anticipated as likely prior to day 90/180 outcome assessment
• Deemed high risk of loss to follow up by research staff.
• Diagnosed pre-existing or new cognitive conditions that would prevent ability to participate in the intervention or outcome assessment.
• Referred or transferred to the Psychiatric Services during the hospitalisation period as identified in medical file
• Severe neurological conditions (e.g. severe traumatic brain injury) that would prevent ability to participate in the intervention or outcome assessment.
• Not expected to return home following discharge
• Lack of either a reliable smartphone with a data plan or internet or a computer with internet, webcam and microphone access; or phone access
• Unable to effectively communicate in English, and that would prevent ability to participate in the intervention or outcome assessment
• Any other reason preventing participants from participating in intervention, including but not limited to: known criminal activity, known personality disorder.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation will be concealed and centralised via a REDCap database. Investigators will become aware of allocation after verbal consent is received, in order to provide adequate notice to intervention participants regarding the timing of the next intervention session to support their attendance.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
An independent statistician will generate a randomisation sequence and randomisation will be administered via a web-based system. Participants will be randomised (1:1) to receive either Intervention Group or Comparator Group .
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Two sample sizes have been calculated for 80% power and 90% power for the primary outcome measure, as recruitment will be contingent on the outcome of grant funding and potential to recruit to the sample size required for 90% power - if a current grant application is successful.
For an 80% power and a two-sided significance level of 0.05 a sample size of 158 survivors (79 in each group) is required. For a 90% power and a two-sided significance level of 0.05 a sample size of 212 survivors (106 in each group) is required. These sample sizes are needed to provide 80% and 90% power respectively to detect a minimal clinically important difference of 8 units (in a comparable population as not established in critical care) in the EQ-5D-5L visual analogue scale at 90-days comparing intervention group to standard care, and a two-sided significance level of 0.05. This is based on a standard deviation of 16.57, allows for 15% loss to follow-up at day 90, and accounts for a conservative correlation of 0.1 between EQ-5D-5L at baseline and 90-days.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
30/08/2024
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Actual
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Date of last participant enrolment
Anticipated
29/08/2025
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Actual
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Date of last data collection
Anticipated
28/02/2025
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Actual
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Sample size
Target
212
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
ACT,VIC
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Recruitment hospital [1]
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Footscray Hospital - Footscray
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Recruitment hospital [2]
26137
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Sunshine Hospital - St Albans
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Recruitment hospital [3]
26138
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Austin Health - Austin Hospital - Heidelberg
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Recruitment hospital [4]
26139
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Eastern Health - Box Hill
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Recruitment hospital [5]
26140
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Bendigo Health Care Group - Bendigo Hospital - Bendigo
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Recruitment hospital [6]
26141
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Royal Melbourne Hospital - City campus - Parkville
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Recruitment hospital [7]
26142
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The Canberra Hospital - Garran
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Recruitment postcode(s) [1]
41995
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3011 - Footscray
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Recruitment postcode(s) [2]
41996
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3021 - St Albans
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Recruitment postcode(s) [3]
41997
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3084 - Heidelberg
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Recruitment postcode(s) [4]
41998
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3128 - Box Hill
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Recruitment postcode(s) [5]
41999
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3550 - Bendigo
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Recruitment postcode(s) [6]
42000
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3050 - Parkville
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Recruitment postcode(s) [7]
42001
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2605 - Garran
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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A/Prof Kimberley Haines
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Address [1]
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Department of Critical Care, The University of Melbourne
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Address
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Country
Australia
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Secondary sponsor category [1]
317856
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None
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Name [1]
317856
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Address [1]
317856
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Country [1]
317856
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314605
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The Royal Melbourne Hospital Human Research Ethics Committee
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Ethics committee address [1]
314605
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https://www.thermh.org.au/research/researchers/ethics
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Ethics committee country [1]
314605
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Australia
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Date submitted for ethics approval [1]
314605
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18/09/2023
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Approval date [1]
314605
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05/03/2024
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Ethics approval number [1]
314605
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Summary
Brief summary
International and local research indicates that Intensive Care Unit (ICU) survivors (patients and families) experience adverse outcomes. In Australia, ICU survivors return home with little or no follow-up. Peer support, which brings survivors together to share experiences, holds potential to improve post-ICU outcomes although this warrants exploration. We have recently developed an in-person peer support model, where we engaged both ICU survivors and staff using a new and innovative method called experience-based co-design (EBCD). We recently tested the feasibility of this co-designed in-person peer support model for ICU survivors via a pilot trial (manuscript under review), that also included an ICU recovery booklet. Despite multiple strategies (including paying for car-parking, and travel costs), there were barriers to participants attending the hospital in-person. Further, the global pandemic necessitated the need to find ways of supporting ICU survivors in their recovery and in a format that did not require in-person attendance at hospital for this program. A further feasibility pilot trial was completed to test a digital format of this co-designed intervention, as well as a digital version of the ICU recovery booklet. This trial found that a digital peer support program and booklet, was feasible to deliver with regards to attendance rates, recruitment, and participant satisfaction. This next study will test these interventions at scale to determine the effectiveness of these interventions across the following two groups: 1. Digital peer support and an ICU recovery booklet; 2. Control care (no formal specialised ICU follow-up or ICU specific recovery information). We hypothesise that the digital peer support program and the recovery booklet will improve the health of participants at 90 days after hospitalisation, with reduced psychological distress, and improved social and informational support and resilience compared to usual care.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Kimberley Haines
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Address
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Sunshine Hospital, Furlong Road, St Albans, Victoria 3021
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Country
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Australia
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Phone
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+61 466417689
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Kimberley Haines
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Address
132155
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Sunshine Hospital, Furlong Road, St Albans, Victoria 3021
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Country
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Australia
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Phone
132155
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+61 466417689
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Fax
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Email
132155
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[email protected]
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Contact person for scientific queries
Name
132156
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Kimberley Haines
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Address
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Sunshine Hospital, Furlong Road, St Albans, Victoria 3021
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Country
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Australia
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Phone
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+61 466417689
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Fax
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Email
132156
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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