A mobile app targeting intensive care unit (ICU) physicians and family members with loved ones who need palliative care worked well to improve communication issues that exist based on race.
The mobile app, ICUconnect, is a communication tool that includes texts and emails to remind family members and doctors to complete tasks such as taking surveys and conducting family meetings. The interface also included videos for families explaining palliative care basics. The tool was used for a seven- to 10-day intervention period. The tool is in development from a grant at Duke University.
A study on the findings was published Thursday in JAMA Network Open.
ICUconnect was designed to address gaps in communication among Black family members who reported worse communication compared to white family members.
Researchers compared the intervention against usual care in six adult medical and surgical ICUs and two academic and community hospitals. All of the facilities were in North Carolina, and data was collected between 2019 and 2002. There were two white patient/family groups and two Black patient family groups enrolled for 37 physicians. All of the patients were on mechanical ventilation.
A total of 111 family members (47 were Black and 64 were white) were included in the study, and the mean age was 51. Of the family members, 86% were women.
The researchers wanted to evaluate scores of the Needs at the End-of-Life Screening Tool (NEST), a scale that indicates greater need the higher the score is. The investigators gauged how people felt after using the app, and also looked at how the family members reported depression, anxiety and post-traumatic stress disorder three months after starting the program.
Intervention participants had better NEST scores between the start and day 3, and day 7 of the program, the data showed. Psychological distress symptoms didn’t vary at three months.
Overall, the app reduced unmet palliative care needs compared to usual care without an app.
“These findings suggest that a mobile application–based intervention is a promising primary palliative care intervention for ICU clinicians that directly addresses the limited supply of palliative care specialists,” the authors wrote.
