Table 1.
Description of study methods
| Study | Intervention | Inclusion Criteria | Study Design, Population, and Follow-Up Period. |
|---|---|---|---|
| Ahrens, Yancey, & Kollef (2003) | Referral to a “communication team” |
Patients who possessed at least one of the following: 1) AIDS diagnosis with CD4 <40/µL 2) Conditions associated with unacceptable quality of life 3) Imminent demise 4) Lethal condition 5) Mechanical ventilation for more than three days 6) NYHA class IV heart failure (ejection fraction less than 20%) |
Design: Non-randomized, controlled trial; N=151 (Control=108; Intervention=43) Population: One MICU No structured follow up period |
| Azoulay et al. (2002) | Family information leaflet | Anticipated ICU length of stay >48 hours |
Design: Randomized controlled trial; N=175 (Control=87; Intervention=88) Population: 17 M/SICUs, 15 MICUs, and 2 SICUs Follow up: between three and five days after study enrollment. |
| Burns et al. (2003) | Social worker interviewed families and provided feedback to clinical team |
All admitted ICU patients eligible | Design: Non-randomized, controlled trial; N=873 (Control=701; Intervention=172). Population: Four SICUs and three MICUs at four teaching hospitals Follow up: Seven days after study enrollment or ICU discharge |
| Campbell & Guzman (2003) | Proactive support approach to end-of-life care |
Patients with global cerebral ischemia (GCI) after cardiac arrest and/or multiple organ system failure (MOSF) |
Design: Retrospective /Prospective comparative cohort study; N=43 (retrospective=40 (MOSF=22; GCI=18); prospective=41 (MOSF=21; GCI=20)) Population: One MICU Follow up: 24 hours before and after a change in patient code status |
| Char, Evans, Malvar, & White (2010) | Two versions of a simulated physician- family cnd-of-life conference |
Surrogate decision makers with any ICU patient |
Design: Randomized controlled trial; N=169 (Numeric version=83; Qualitative=86) Population: Two M/SICUs, one NICU, and one CICU Follow up: No structured follow up period |
| Connors et al. (1995) | Physicians provided with prognostic reports, patient outcome desires, functional disability reports; nurses served as liaison between families and physicians to elicit preferences, improve understanding, and facilitate advance care planning |
Advanced stage of one or more of following illnesses: 1) Acute respiratory failure 2) Multiple organ system failure with sepsis/malignancy 3) Coma 4) Chronic obstructive lung disease 5) Congestive heart failure 6) Cirrhosis 7) Metastatic colon cancer 8) Non-small cell lung cancer |
Design: Phase 1: Prospective, observational study; N=4301 Phase 2: Cluster, randomized, controlled, clinical trial; N=4804 (control=2152; intervention=2652) Population: ICUs from five medical centers across the United States Follow up: Phase 1 – between days 2 and 7, 6 and 15, and 4 to 10 weeks after patient death Phase II – Prognostic measures: study days 2, 4, 8, 10, 15, and 26 Study nurse measures: study day 3 and continuously until patient death or six months later |
| Cox et al. (2012) | Prolonged mechanical ventilation decision aid |
1) At least 18 years of age 2) Identified as most involved in medical decision making 3) Mechanically ventilated for at least ten days |
Design: Phase 1: Methodological development of decision aid Phase 2: Prospective before/after design N=27 surrogates (before=10; after=17) Population: One Surgical, one trauma, one neurological, one cardiac, and one medical ICU within two academic medical centers Follow up: Within two days after occurrence of family meeting |
| Daly et al. (2010) | Intensive Communication Structure (ICS) |
1) 72 hours MV 2) Lack of decisional capacity OR Glasgow Coma Scale <6 3) Not on MV prior to admission 4) Having an identified surrogate decision maker |
Design: Non-randomized, controlled trial; N=481 (control=135; experimental=346) Population: Two MICU, two SICU, and one NICU from two medical centers within the same city Follow up: At least weekly after initial meeting |
| Dowdy, Robertson, & Bander (1998) | Ethics consultation service | More than 96 hours of MV | Design: Non-randomized, controlled trial; N=99 (baseline=37; control=31; proactive=31) Population: One hospital ICU Follow up: No structured follow up period |
| Dowling & Wang (2005) | Critical Care Family Assistance Program |
Individuals with a family member at study site ICU |
Design: Non-randomized pre/post intervention trial; N=330 Population: Two different hospital ICUs Follow up: No structured follow up period |
| Hatler, Grove, Strickland, Barron, & White (2012) | Surrogacy information and decision-making tool and SDM pamphlet for patients/family members |
1) At least 96 hours of MV OR 2) ICU LOS of at least seven days |
Design: Non-randomized, pre/post intervention trial; N=203 (pre- intervention=105; post- intervention=98) Population: One NICU Follow up: No structured follow up period |
| Kaufer, Murphy, Barker, & Mosenthal (2008) | Palliative-care emphasis intervention |
Family of patients who died in the ICU |
Design: Non-randomized pre/post- intervention trial; N=88 (pre- intervention=43; post- intervention=45) Population: One MICU Follow up: 2–16 months after patient death |
| Kodali et al. (2014) | Family communication pathway |
Neurosurgical ICU patients’ next of kin |
Design: Quasi-experimental, pre/post intervention design (pre- intervention=26; post- intervention=86) Population: Unspecified ICU Follow up: 2–6 weeks after patient discharge |
| Lamba, Murphy, McVicker, Harris Smith, & Mosenthal (2012) | Structured palliative care program |
Liver transplant service patients | Design: Prospective, observational, pre/post-study; N=183 (baseline=79; intervention=104; baseline deaths=21, intervention deaths=31) Population: One SICU Follow up: No structured follow up period |
| Lautrette et al. (2007) | Structured end-of-life family conferences and bereavement brochure |
Physician prognosis of patients imminent death |
Design: Randomized controlled trial; N=126 (control=63; intervention=63) Population: One MICU and one SICU Follow up: 90 days after patient death |
| Lilly et al. (2000) | Intensive communication intervention |
All adults admitted to the study ICU |
Design Prospective, non-blinded, change-of-practice intervention; N- 530 (pre-intervention=134; intervention=396) Population: One MICU Follow up: Daily |
| McCannon et al. (2012) | Decision support CPR video |
SDM of patients who were: 1) >50 years old 2) Unable to make medical decisions 3) Likely to survive >24 hours |
Design: Quasi-experimental, pre-post intervention; N=50 (pre- intervention=23; post- intervention=27) Population: One MICU Follow up: No structured follow up period |
| Mosenthal et al. (2008) | Palliative care bundle | All adults admitted to the trauma- SICU |
Design: Prospective, observational, pre/post-study; N=633 (baseline=266; intervention=367) Population: Trauma SICU Follow up: Three days after study enrollment |
| Norton et al. (2007) | Palliative care consultations |
One of following: 1) ICU admission following current hospital stay ≥ 10 days 2) Greater than 80-years-old with at least two life-threatening co- morbidities 3) Active stage IV malignancy 4) Post cardiac arrest 5) Intracerebral hemorrhage requiring mechanical ventilation |
Prospective, pre/post nonequivalent control design; N=191 (usual care=65; intervention=126) Population: One MICU Follow up: No structured follow up period |
| Schneiderman et al. (2003) | Ethics consultation | Identified by nursing rounds as adult patients with a potential for value laden treatment decision conflicts |
Prospective, multicenter, randomized controlled trial; N=546 (usual care=270; intervention=276) Population: Adult ICUs at seven United States’ hospitals Follow up: No structured follow up period |
| Shelton, Moore, Socaris, Gao, & Dowling (2010) | Family support coordinator | Anticipated LOS ≥ 5 days | Quasi-experimental pre/post-test design; N=227 (pre=114; post=113) Population: One SICU Follow up: No structured follow up period |
| Wilson et al. (2015) | Video including a simulated hospital code blue and an explanation of resuscitation preference options |
Patients and/or surrogate decision makers of patients within 48-hours of ICU admission |
Randomized, unblinded trial; N=200 (100 usual care and 100 video group) Population: One MICU Follow up: No structured follow up |
Note. NYHA = New York Heart Association; LOS = length of stay; ICU = intensive care unit; MOSF = multi-organ system failure; GCI= global cerebral ischemia; CPR = cardiopulmonary resuscitation; MICU = medical intensive care unit; SICU = surgical intensive care unit; NICU = neurological intensive care unit; CICU = cardiac intensive care unit