Optimizing Recovery Following Critical Illness: A Systematic Review of Home-Based Interventions

Abstract

Around 5 million Americans are treated in an intensive care unit (ICU) annually. Upon discharge, it is not uncommon for ICU

survivors to experience psychological, physical, or cognitive symptoms related to their ICU stay. Home-based interventions

have been touted as a potential treatment modality for post-ICU sequelae. However, limited evidence exists regarding the

effectiveness of home-based interventions for patients in the post-ICU recovery period. As such, the purpose of this review

was to aggregate and summarize the findings of studies focused on post-ICU rehabilitation, following critical illness, delivered

in the home setting. A literature search was performed in MEDLINE, CINAHL, EMBASE, APA PsycINFO, and Google

Scholar. Studies were included if they: used a RCT or quasi-experimental study design; included participants aged ≥18 years

discharged home from an ICU; examined the effectiveness of a home-based, post-ICU intervention; were published in English

after the year 2010; and were peer-reviewed. Nine studies met inclusion criteria. Sample sizes ranged from 21 to 386, with

most participants receiving mechanical ventilation. Target outcomes included: physical function, psychological well-being,

cognitive function, quality of life, and healthcare utilization. Interventions included face-to-face, web-based, telephone, or

self-directed activities. Findings of included studies were mixed or inconclusive. Limitations of this review include: inclusion of

only adult ICU survivors, exclusion of Post-Intensive Care Syndrome as a search term, and search restricted to pre-pandemic

studies. Findings suggest a need for more rigorous research to develop and test home-based interventions.