A Randomized Controlled Trial of a Post-ICU Telehealth Care Model (WFIT)

Area of Science:

• Critical Care Medicine
• Health Services Research
• Digital Health Interventions

Background:

• Survivors of critical illness face significant risks of long-term adverse outcomes, including hospital readmissions, diminished quality of life, and mortality.
• Post-intensive care unit (ICU) recovery presents a critical window for intervention to mitigate these long-term effects.
• Telehealth models offer a potential avenue for structured follow-up care after ICU discharge.

Purpose of the Study:

• To evaluate the cost-effectiveness of a post-ICU telehealth care model.
• To assess the clinical efficacy of this telehealth intervention in improving outcomes for critical illness survivors.

Main Methods:

• A single-center randomized controlled trial involving 400 ICU patients with sepsis and/or acute respiratory failure.
• The intervention group received scheduled telehealth visits post-ICU discharge and as-needed support for six months.
• The control group received standard care, with the primary outcome being cost-effectiveness.

Main Results:

• Overall healthcare spending on emergency room visits and hospitalizations showed no significant incremental net benefit in the telehealth group compared to the control group.
• Patient-reported emergency room visits to outside hospitals were significantly higher in the telehealth intervention group (2.43 vs. 0.97 per 100 patients per month; P=0.03).
• Key outcomes such as readmissions, mortality, quality of life, and patient satisfaction were similar between the intervention and control groups.

Conclusions:

• The post-ICU telehealth intervention, while demonstrating variability, did not provide a clear incremental net benefit in cost-effectiveness compared to standard care.
• The study highlights the need for further research into optimizing telehealth interventions for post-ICU recovery.
• The trial was registered on clinicaltrials.gov (NCT04576065).