POST-INTENSIVE CARE SYNDROME

To recognize that multidimensional rehabilitation is essential for recovery after intensive care; further,

To support research on and dissemination of best practices in the prevention, identification, and treatment of post-intensive care syndrome (PICS) in patients of all ages; further,

To advocate that health systems support the development and implementation of interdisciplinary clinics, inclusive of pharmacists, to treat patients with PICS, including provisions for telehealth and innovative practice models to meet the needs of patients with PICS; further,

To advocate for the integration of post-ICU patient and ICU caregiver support groups; further,

To provide education on the role of the pharmacist in caring for patients with PICS. 

Rationale

Post-intensive care unit (post-ICU) rehabilitation is essential for recovery after critical illness. Post-intensive care syndrome (PICS) is a conglomerate of new or worsening multidimensional impairments in physical, psychological, cognitive, and social status arising from critical illness that continue after hospital discharge. PICS is associated with high morbidity among patients discharged from ICUs, with 30-80% of patients having issues with remembering, paying attention, solving problems, or organizing and working on complex tasks.

The burden of PICS continues to grow. With only up to 50% of patients with PICS able to return to work within the first year, some are unable to return to the jobs they had before their illness and need help with activities after leaving the hospital. While PICS is widely discussed across medical disciplines, it not well defined, nor are ways to prevent and treat this disorder well researched. It is recognized that patients with PICS require a multidimentional, interdisciplinary treatment effort, including cognitive rehabilitation, mental health treatment, and intensive transitions of care interventions, as patients may be discharged on medications that should not be continued and they may need support to resume daily activities. The rapid COVID-19-related increase in patients requiring the use of ICUs has exacerbated the demand for high-quality PICS care, but the simultaneous expansion of telemedicine and other innovative patient care models has shown that rapid changes in team-based care can be achieved with the proper incentives and flexibilities.