Joanne McPeake1,2, Mark E Mikkelsen3, Tara Quasim2, Elizabeth Hibbert4, Paul Cannon5, Martin Shaw1, Jane Ankori1, Theodore J Iwashyna6,7, Kimberley J Haines4,8. 1. NHS Greater Glasgow and Clyde. 2. School of Medicine, Dentistry and Nursing, and. 3. Division of Pulmonary, Allergy, and Critical Care Medicine, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. 4. Department of Physiotherapy, Western Health, Melbourne, Victoria, Australia. 5. Library, University of Glasgow, Glasgow, United Kingdom. 6. Division of Pulmonary & Critical Care, Department of Medicine, University of Michigan, Ann Arbor, Michigan. 7. Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan; and. 8. Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
Abstract
Background: Patients who survive critical illness have well-defined physical, cognitive, emotional, and familial problems. However, the impact of these problems on survivors' ability to return to work and other financial outcomes is less clear. Objectives: To determine the financial and employment consequences of an intensive care stay, we performed a systematic review and meta-analysis.Data Sources: We searched the MEDLINE, Embase, and CINAHL databases (1970-2018). All publication types except narrative reviews, case reports, case-control studies, and editorials were included. Included studies assessed financial outcomes in patients admitted to critical care and their caregivers.Data Extraction: Two reviewers independently applied eligibility criteria, assessed quality, and extracted data. The primary outcome reported was return to employment among those previously employed. We also examined financial stress and the impact financial outcomes had on quality of life and psychosocial health.Data Synthesis: Of 5,765 eligible abstracts, 51 studies were included, which provided data on 858 caregivers/family members and 7,267 patients. Forty-two papers reported patient outcomes, and 11 papers described caregivers/family members. Two papers included data from both patients and caregivers/family members. Return to employment was the most commonly reported financial outcome for critical care survivors. The pooled estimates for return to employment among those who were employed before critical illness were 33% (95% confidence interval [CI], 21-48%), 55% (95% CI, 45-64%), and 56% (95% CI, 45-66%) at 3, 6, and 12 months, respectively. Across the studies included in this review, there was a positive association with psychosocial health if patients returned to employment. This included improved health-related quality of life and fewer depressive symptoms. Regarding caregivers/family members, six studies reported changes in employment such as reduced hours and lost earnings.Conclusions: After critical illness, many patients who were previously employed do not return to work, even one year later. This new job loss is associated with worse health-related quality of life among survivors and worse psychological function among survivors and caregivers/family members. More interventional research is required to understand how best to support employability after critical illness.Registered with PROSPERO (CRD42018102360).
Background: Patients who survive critical illness have well-defined physical, cognitive, emotional, and familial problems. However, the impact of these problems on survivors' ability to return to work and other financial outcomes is less clear. Objectives: To determine the financial and employment consequences of an intensive care stay, we performed a systematic review and meta-analysis.Data Sources: We searched the MEDLINE, Embase, and CINAHL databases (1970-2018). All publication types except narrative reviews, case reports, case-control studies, and editorials were included. Included studies assessed financial outcomes in patients admitted to critical care and their caregivers.Data Extraction: Two reviewers independently applied eligibility criteria, assessed quality, and extracted data. The primary outcome reported was return to employment among those previously employed. We also examined financial stress and the impact financial outcomes had on quality of life and psychosocial health.Data Synthesis: Of 5,765 eligible abstracts, 51 studies were included, which provided data on 858 caregivers/family members and 7,267 patients. Forty-two papers reported patient outcomes, and 11 papers described caregivers/family members. Two papers included data from both patients and caregivers/family members. Return to employment was the most commonly reported financial outcome for critical care survivors. The pooled estimates for return to employment among those who were employed before critical illness were 33% (95% confidence interval [CI], 21-48%), 55% (95% CI, 45-64%), and 56% (95% CI, 45-66%) at 3, 6, and 12 months, respectively. Across the studies included in this review, there was a positive association with psychosocial health if patients returned to employment. This included improved health-related quality of life and fewer depressive symptoms. Regarding caregivers/family members, six studies reported changes in employment such as reduced hours and lost earnings.Conclusions: After critical illness, many patients who were previously employed do not return to work, even one year later. This new job loss is associated with worse health-related quality of life among survivors and worse psychological function among survivors and caregivers/family members. More interventional research is required to understand how best to support employability after critical illness.Registered with PROSPERO (CRD42018102360).
Authors: Tammy L Eaton; Leslie P Scheunemann; Brad W Butcher; Heidi S Donovan; Sheila Alexander; Theodore J Iwashyna Journal: Crit Care Explor Date: 2022-04-08
Authors: Aluko A Hope; Andrea Annie Johnson; Joanne McPeake; Hali Felt; Carla M Sevin; Mark E Mikkelsen; Theodore J Iwashyna; Caroline Lassen-Greene; Kimberley J Haines; Sachin Agarwal; Rita N Bakhru; Leanne M Boehm; Brad W Butcher; Kelly Drumright; Tammy L Eaton; Elizabeth Hibbert; Karen Sara Hoehn; David Hornstein; Heather Imperato-Shedden; James C Jackson; Janet A Kloos; Anna Lewis; Joel Meyer; Ashley Montgomery-Yates; Veronica Rojas; Christa Schorr; Dorothy Wade; Cydni Williams Journal: Am J Crit Care Date: 2021-02-15 Impact factor: 2.207
Authors: Joanne McPeake; Leanne M Boehm; Elizabeth Hibbert; Rita N Bakhru; Anthony J Bastin; Brad W Butcher; Tammy L Eaton; Wendy Harris; Aluko A Hope; James Jackson; Annie Johnson; Janet A Kloos; Karen A Korzick; Pamela MacTavish; Joel Meyer; Ashley Montgomery-Yates; Tara Quasim; Andrew Slack; Dorothy Wade; Mary Still; Giora Netzer; Ramona O Hopkins; Mark E Mikkelsen; Theodore J Iwashyna; Kimberley J Haines; Carla M Sevin Journal: Crit Care Explor Date: 2020-04-29
Authors: Carly Robinson; Elizabeth Hibbert; Anthony J Bastin; Joel Meyer; Ashley Montgomery-Yates; Tara Quasim; Andrew Slack; Mark E Mikkelsen; Theodore J Iwashyna; Kimberley J Haines; Carla M Sevin; Joanne McPeake; Leanne M Boehm Journal: Crit Care Explor Date: 2020-11-19
Authors: Catherine L Auriemma; Michael O Harhay; Kimberley J Haines; Frances K Barg; Scott D Halpern; Sarah M Lyon Journal: Am J Crit Care Date: 2021-01-01 Impact factor: 2.228
Authors: Joanne McPeake; Theodore J Iwashyna; Philip Henderson; Alastair H Leyland; Daniel Mackay; Tara Quasim; Matthew Walters; Michael Harhay; Martin Shaw Journal: Lancet Reg Health Eur Date: 2021-07
Authors: Frances R Nedjat-Haiem; Tamara Cadet; Humberto Parada; Tessa Jones; Elvira E Jimenez; Beti Thompson; Kristen J Wells; Shiraz I Mishra Journal: Am J Hosp Palliat Care Date: 2020-11-06 Impact factor: 2.090
Authors: Katrina E Hauschildt; Claire Seigworth; Lee A Kamphuis; Catherine L Hough; Marc Moss; Joanne M McPeake; Theodore J Iwashyna Journal: Crit Care Med Date: 2020-08 Impact factor: 9.296