Project description
Sustainable palliative care for ICU patients
Approximately 10 % of individuals admitted to an intensive care unit (ICU) ultimately succumb to their illness. These patients often endure distressing symptoms and may receive more aggressive life-prolonging treatments than they would have desired. Moreover, their family members experience prolonged distress as a result of the experience. The EU-funded EPIC project aims to enhance sustainable palliative care for critically ill patients and their families in the ICU through a harmonised telemedicine-based practice model. The project adopts a systems-based approach, incorporating proactive patient identification, checklists, and blended learning. A randomised trial is employed to evaluate the effectiveness of the new model. Additionally, the project develops an evidence-based patient decision aid and addresses barriers for tele-palliative care.
Objective
About 10% of all decedents in the population die after admission to an intensive care unit (ICU). These patients often have distressing symptoms and may receive more intense life-prolonging treatment than they would have chosen, their family members often experience lasting distress from the experience and many ICU physicians and nurses are burdened by their perception of potentially non-beneficial care.
The EPIC project aims to sustainably improve palliative care for critically ill patients and their families in the ICU. An interdisciplinary consortium collaborates to provide a novel harmonized palliative care practice model using telemedicine. The project is the first European interventional study on palliative care in the ICU, using a systems-based approach with proactive patient identification, checklist and blended learning targeted to specific requirements of ICU clinicians. Effectiveness of the new model is assessed through a stepped wedge randomized trial with 7 clinical centers from 5 European countries, 23 multi-disciplinary ICUs and enrolment of 2001 patients. Primary outcome is a reduction in ICU stay to relieve suffering. Cost implications and cost effectiveness will be assessed from different perspectives. An evidence-based patient decision aid for critically ill patients is developed. Additional outcomes serve deepen our understanding of barriers and facilitators and provide ethical recommendations for the use of telepalliative care in civic society.
The vision of EPIC is to contribute to a mind shift from a narrow focus on prolonging life towards more holistic care. A European patient and family advisory group is implemented to engage patients and family members from the start and co-create open-access information to increase acceptance of palliative care. Telemedicine offers a low-cost solution to spread the model to all regions in Europe and open new avenues for patient-centered care.
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HORIZON-RIA - HORIZON Research and Innovation ActionsCoordinator
10117 Berlin
Germany