In a study appearing in the June 28 issue of JAMA, Jochen Gensichen, MD, MSc, MPH, of Jena University Hospital, Jena, Germany, and colleagues randomly assigned 291 patients who survived sepsis (including septic shock) to usual care (n = 143) or to a 12-month intervention (n = 148) to assess whether the primary care-based intervention would improve mental health-related quality of life.
Sepsis is a major health problem worldwide. It has been estimated that sepsis occurred in 2 percent of hospitalized patients in the United States in 2008, and incidence is expected to increase further in the future, with an even higher incidence in developing countries. Survivors of sepsis face long-term consequences that diminish health-related quality of life and result in increased care needs in the primary care setting, such as medication, physiotherapy, or mental healthcare.
For this study, usual care was provided by the patient’s primary care physician (PCP) and included periodic contacts, referrals to specialists, and prescription of medication, other treatment, or both. The intervention additionally included PCP and patient training, case management provided by trained nurses, and clinical decision support for PCPs by consulting physicians. At 6 and 12 months after intensive care unit discharge, 75 percent and 69 percent of patients, respectively, completed follow-up. The researchers found there was no significant difference in change of scores that measured mental health-related quality of life.
“Further research is needed to determine if modified approaches to primary care management may be more effective,” the authors write.