Additional support by palliative care specialists failed to improve anxiety and depression symptoms in caregivers of patients with chronic critical illness, according to new research presented at the ATS 2016 International Conference. Patients also saw little benefit as the additional support did not lead to reduced time on a breathing machine or in the hospital.
“Family members indicated that they were satisfied with the information and support provided by the ICU physicians, and this may explain why the additional support from palliative care specialists did not improve family or patient outcomes,” said Shannon Carson, MD, of the University of North Carolina at Chapel Hill in Chapel Hill, North Carolina.
The study enrolled 256 adult patients and their caregivers from medical ICUs at three tertiary care centers and one community hospital. To be eligible, patients had to require at least seven days of mechanical ventilation. Patients were randomized to either usual care or two meetings with a palliative care physician and nurse practitioner.
Given that palliative care specialists, who are trained to provide emotional support and share difficult information, are routinely consulted to provide family support and facilitate goals of care discussions for chronically critically ill patients, the authors wanted to determine if these specialists would help to reduce psychological stress for families.
“Findings of our study indicate that routine referral of these patients for palliative care consultation does not improve psychological distress for families as compared to effective communication by ICU physicians,” said Dr Carson. “ICU physicians should continue to make
communication and support for family decision-makers an important part of their practice in the ICU. They should meet with families early and provide additional support as needed. Support for this physician effort by insurers is a good use of resources.”
