Efectividad de un programa de seguimiento específico para el manejo de los componentes mentales del síndrome poscuidados intensivos y el dolor crónico tras la enfermedad por coronavirus de 2019: resultados del ensayo clínico aleatorizado “PAIN-COVID”

A. Ojeda , A. Calvo , T. Cuñat , R. Mellado-Artigas , A. Costas-Carrera , M.M. Sánchez-Rodriguez , O. Comino-Trinidad , J. Aliaga , M. Arias , G. Martínez-Pallí , C. Dürsteler , C. Ferrando
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Abstract

Background

Critical COVID-19 survivors are at risk of developing Post-intensive Care Syndrome (PICS) and Chronic ICU-Related Pain (CIRP). We determined whether a specific care program improves the quality of life (QoL) of patients at risk of developing PICS and CIRP after COVID-19 disease.

Methods

The PAIN-COVID trial was a parallel-group, single-centre, single-blinded, randomized controlled trial. The intervention consisted of a follow up program, patient education on PICS and pain, and a psychological intervention based on Rehm's self-control model in patients with abnormal depression scores (> = 8) in the Hospital Anxiety and Depression Scale (HADS) at the baseline visit. QoL was evaluated with the 5-level EQ 5 D (EQ 5 D 5 L), mood disorders with the HADS, post-traumatic stress disorder (PTSD) with the PCL-5 checklist, and pain with the Brief Pain Inventory short form, the Douleur Neuropathique 4 questionnaire, and the Pain Catastrophizing Scale. The primary outcome was to determine if the program was superior to standard-of-care on the EQ visual analogue scale (VAS) at 6 months after the baseline visit. The secondary outcomes were EQ VAS at 3 months, and EQ index, CIRP incidence and characteristics, and anxiety, depression, and PTSD at 3 and 6 months after baseline visits.

Conclusions

This program was not superior to standard care in improving QoL in critical COVID-19 survivors as measured by the EQ VAS. However, our data can help establish better strategies for the study and management of PICS and CIRP in this population.

Trial registration: # NCT04394169, registered on 5/19/2020.

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针对 COVID-19 感染后重症监护室后综合征和慢性疼痛的精神因素管理的特定后续计划的有效性:随机临床试验 DOLOR-COVID 的结果
背景COVID-19重症幸存者有患重症监护后综合征(PICS)和慢性重症监护病房相关疼痛(CIRP)的风险。我们确定了一项特定护理计划是否能改善 COVID-19 病后有可能患重症监护后综合征和慢性重症监护相关疼痛的患者的生活质量(QoL)。方法 PAIN-COVID 试验是一项平行组、单中心、单盲、随机对照试验。干预措施包括随访计划、PICS 和疼痛方面的患者教育,以及基于雷姆自我控制模型的心理干预,干预对象为基线访问时在医院焦虑和抑郁量表(HADS)中抑郁评分异常(> = 8)的患者。患者的 QoL 评估采用 5 级 EQ 5 D (EQ 5 D 5 L),情绪障碍采用 HADS,创伤后应激障碍(PTSD)采用 PCL-5 核对表,疼痛采用简明疼痛量表简表、Douleur Neuropathique 4 问卷和疼痛灾难化量表。主要结果是确定该计划在基线访问后 6 个月的 EQ 视觉模拟量表(VAS)上是否优于标准护理。次要结果是 3 个月时的 EQ VAS,以及基线访问后 3 个月和 6 个月时的 EQ 指数、CIRP 发生率和特征,以及焦虑、抑郁和创伤后应激障碍。不过,我们的数据有助于为研究和管理该人群中的 PICS 和 CIRP 制定更好的策略:# NCT04394169,注册日期:2020年5月19日。
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来源期刊
CiteScore
1.80
自引率
15.40%
发文量
113
审稿时长
82 days
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