1580: TELEMEDICINE ICU RECOVERY CARE: PATIENT OUTCOMES FROM THE TELEPORT PILOT RANDOMIZED CONTROLLED TRIAL

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Introduction: Post-intensive care syndrome (PICS) encompasses multidimensional impairments in survivors of critical illness. ICU Recovery Clinics (ICU-RC) were developed to manage PICS impairments, but disability can limit attendance. We evaluated the preliminary efficacy of a telemedicine ICU-RC for improving PICS outcomes. Methods: We conducted a pilot randomized controlled trial (1:1) with medical and surgical ICU patients with septic shock and/or acute respiratory distress syndrome (N=91). Intervention patients (n=46) received multidisciplinary (ICU physician, pharmacist, psychologist) telemedicine ICU-RC visits at 3- and 12-weeks post-discharge. Controls (n=45) received standard care. A blinded research assistant assessed outcomes at 1 week and 6 months post-discharge using validated instruments: PROMIS scales (cognitive, depression, anxiety, physical function, global quality of life), Montreal Cognitive Assessment-blind [MoCA], and PTSD Checklist. Linear mixed-effects regression analyzed between-group differences over time, adjusting for baseline scores and education level. Results: Participants were middle-aged (median=56), White (92%), and 51% male. In the telemedicine group, 23 attended at least one ICU-RC visit, with attendance rates of 60% at 3 weeks and 49% at 12 weeks. Median visit duration decreased from 52 minutes at 3 weeks to 34 minutes at 12 weeks. Outcome measures generally improved from 1 week to 6 months across both telemedicine and control groups. In the analytic sample, PROMIS physical function scores significantly improved from 1 week to 6 months (β=9.8, p< 0.001). After adjusting for education level, there was a significant group-by-time interaction for PROMIS Global mental health scores, favoring the telemedicine group (adjusted β=5.4, p=0.049). There were no other statistically significant group-by-time interactions for the remaining PICS measures (i.e., PROMIS cognitive, depression, anxiety, physical function; MoCA; PTSD Checklist). Conclusions: This feasibility study was not powered to determine intervention efficacy. However, telemedicine ICU-RC was associated with improved PROMIS Global Mental Health scores compared to usual care. Future adequately powered trials should assess ICU-RC effectiveness on PICS outcomes across telemedicine, in-person, and hybrid delivery models.

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