Descrizione del progetto
Cure palliative sostenibili per i pazienti in terapia intensiva
Circa il 10 % delle persone ricoverate in un'unità di terapia intensiva (UTI) alla fine soccombe alla propria malattia. Questi pazienti spesso sopportano sintomi angoscianti e possono ricevere trattamenti di prolungamento della vita più aggressivi di quanto avrebbero desiderato. Inoltre, i loro familiari provano un’angoscia prolungata a causa di questa esperienza. Il progetto EPIC, finanziato dall’UE, intende migliorare le cure palliative sostenibili per i pazienti critici e le loro famiglie in terapia intensiva attraverso un modello di pratica armonizzato basato sulla telemedicina. Il progetto adotta un approccio basato sui sistemi, incorporando l’identificazione proattiva dei pazienti, le liste di controllo e l’apprendimento misto. Per valutare l’efficacia del nuovo modello si ricorre a uno studio randomizzato. Inoltre, il progetto sviluppa un ausilio decisionale per i pazienti basato sull’evidenza e affronta le barriere per le cure tele-palliative.
Obiettivo
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 ActionsCoordinatore
10117 Berlin
Germania