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Trial registered on ANZCTR
Registration number
ACTRN12619000917134
Ethics application status
Approved
Date submitted
12/06/2019
Date registered
1/07/2019
Date last updated
10/11/2021
Date data sharing statement initially provided
1/07/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Communication with bereaved family members after death in the Intensive Care Unit
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Scientific title
Communication with bereaved family members after death in the Intensive Care Unit
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Secondary ID [1]
298459
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
CathartiC
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Depression
313201
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Anxiety
313202
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Post-traumatic stress disorder
313203
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Complicated grief
313204
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Condition category
Condition code
Mental Health
311662
311662
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0
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Depression
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Mental Health
311663
311663
0
0
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Anxiety
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Mental Health
311664
311664
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0
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Other mental health disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The legal representative of a patient who has recently died while receiving treatment in the Intensive Care Unit will receive one of three interventions as part of a bereavement follow up:
Group A is the control group (please see below).
Group B will receive a short, semi-structured telephone call from a Clinical Nurse Consultant (senior Intensive Care Nurse) four weeks following the death.
The telephone call is expected to last less than 5 minutes in duration and will have 2 objectives:
i/ Expression of condolences.
ii/ Offer of further telephone call or in-person meeting with a representative from the Intensive Care Unit.
Group C will not receive any communication from the Intensive Care Unit following the death.
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Intervention code [1]
314701
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Behaviour
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Comparator / control treatment
The legal representative of a patient who has recently died while receiving treatment in the Intensive Care Unit will receive one of three interventions as part of a bereavement follow up:
Group A will receive a standardised condolence letter four weeks following the death. This is current standard practice and consequently has been selected as the control group. The condolence letter serves 2 objectives:
i/ Expression of condolences.
ii/ Provision of contact details should further contact with a representative of the ICU or hospital be desired.
Group B and C are intervention groups, as detailed above.
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Control group
Active
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Outcomes
Primary outcome [1]
320368
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Incidence of anxiety and depression, as determined by a total Hospital Anxiety and Depression Score (HADS-T) of greater than or equal to 11/42.
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Assessment method [1]
320368
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Timepoint [1]
320368
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The Hospital Anxiety and Depression Scale assessment tool will be measured at 6 months following the death.
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Secondary outcome [1]
371373
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Incidence of anxiety, as determined by a Hospital Anxiety and Depression Scale, Anxiety sub-scale score (HADS-A) of greater than or equal to 8/21.
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Assessment method [1]
371373
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Timepoint [1]
371373
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The Hospital Anxiety and Depression Scale assessment tool will be measured at 6 months following the death.
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Secondary outcome [2]
371374
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Incidence of depression, as determined by a Hospital Anxiety and Depression Scale, Depression sub-scale score (HADS-D) of greater than or equal to 8/21.
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Assessment method [2]
371374
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Timepoint [2]
371374
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The Hospital Anxiety and Depression Scale assessment tool will be measured at 6 months following the death.
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Secondary outcome [3]
371375
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Incidence of Post-Traumatic Stress Disorder, as determined by an' Impact of Event Scale - Revised' score of greater than or equal to 33/88.
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Assessment method [3]
371375
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Timepoint [3]
371375
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The 'Impact of Event Scale - Revised' assessment tool will be measured at 6 months following the death.
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Secondary outcome [4]
371376
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Incidence of Complicated Grief, as determined by an 'Inventory of Complicated Grief' score of greater than or equal to 25/76.
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Assessment method [4]
371376
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Timepoint [4]
371376
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The 'Inventory of Complicated Grief' assessment tool will be measured at 6 months following the death.
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Secondary outcome [5]
371377
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Incidence of Complicated Grief, as determined by an 'CAESAR' score of less than or equal to 59/75.
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Assessment method [5]
371377
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Timepoint [5]
371377
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The 'CAESAR' assessment tool will be measured at 6 months following the death.
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Eligibility
Key inclusion criteria
Intensive Care Unit Patient Criteria:
i/ Aged greater than 18 years of age
ii/ Non-pregnant
iii/ Admitted to the Intensive Care Unit as a patient for greater than 24 hours
Legal Representative of Patient Criteria:
i/ Legal representative of patient
ii/ Aged greater than 18 years of age
iii/ Visited patient on one or more occasions during their Intensive Care Unit stay
iv/ Attended one or more Intensive Care Unit family meetings
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Legal Representative of Patient:
- Has limited understanding of English.
- Has multiple relatives admitted to the Intensive Care Unit.
- Is expected not to be contactable by phone or mail at 6 months follow up.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation concealment will be maintained until after randomisation, with investigators informed of treatment group via RedCap. The subset of investigators undertaking the six-month follow-up will not have the treatment allocation available to them, however if the participant chooses to reveal which intervention they were subject to this cannot be avoided.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Selection bias will be minimised by with randomisation schedule using a fixed seed number, and thus a reproducible schedule, using Stata (Stata version 15.1, College Station, Texas) routine ralloc. The seed number will be kept securely so the sequence can be re-generated and if necessary extended as desired.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
This small pilot study will focus on comparing descriptive statistics (means, proportions, medians) and their associated confidence intervals or quantile ranges between the three groups, to provide an estimate of possible treatment effects.
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Recruitment
Recruitment status
Stopped early
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Data analysis
Data analysis is complete
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Reason for early stopping/withdrawal
Other reasons/comments
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Other reasons
Ceased recruitment on 24th March 2020 due to impact of COVID pandemic on ICU resources, case mix and model of care in Melbourne, Victoria
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Date of first participant enrolment
Anticipated
1/07/2019
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Actual
12/08/2019
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Date of last participant enrolment
Anticipated
30/06/2020
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Actual
24/03/2020
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Date of last data collection
Anticipated
30/12/2020
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Actual
16/09/2020
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Sample size
Target
200
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Accrual to date
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Final
76
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
13971
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Royal Melbourne Hospital - City campus - Parkville
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Recruitment postcode(s) [1]
26746
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3052 - Parkville
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Funding & Sponsors
Funding source category [1]
303002
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Hospital
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Name [1]
303002
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Melbourne Health
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Address [1]
303002
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Melbourne Health
Royal Melbourne Hospital
300 Grattan Street
Parkville VIC 3050
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Country [1]
303002
0
Australia
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Primary sponsor type
Hospital
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Name
Melbourne Health
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Address
Melbourne Health
Royal Melbourne Hospital
300 Grattan Street
Parkville VIC 3050
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Country
Australia
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Secondary sponsor category [1]
302994
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None
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Name [1]
302994
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Address [1]
302994
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Country [1]
302994
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
303551
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Melbourne Health Human Research Ethics Committee
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Ethics committee address [1]
303551
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Office for Research The Royal Melbourne Hospital Level 2 South West 300 Grattan Street Parkville VIC 3050
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Ethics committee country [1]
303551
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Australia
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Date submitted for ethics approval [1]
303551
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27/03/2019
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Approval date [1]
303551
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23/05/2019
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Ethics approval number [1]
303551
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HREC/52855/MH-2019
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Summary
Brief summary
Twenty-two French ICUs published in 2017 found worse outcomes in bereaved relatives that received a condolence letter compared to no follow up. By comparing three communication strategies: a condolence letter, a telephone call and no contact, our pilot study aims to determine which of these interventions administered four weeks after death is associated with the lowest rate of anxiety, depression, complicated grief and PTSD when assessed at six months.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
94058
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Dr Laurie Showler
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Address
94058
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Intensive Care Unit
Royal Melbourne Hospital
Level 5, B building
300 Grattan Street
Parkville VIC 3050
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Country
94058
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Australia
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Phone
94058
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+61 416958489
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Fax
94058
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Email
94058
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[email protected]
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Contact person for public queries
Name
94059
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Laurie Showler
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Address
94059
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Intensive Care Unit
Royal Melbourne Hospital
Level 5, B building
300 Grattan Street
Parkville VIC 3050
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Country
94059
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Australia
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Phone
94059
0
+61 416958489
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Fax
94059
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Email
94059
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[email protected]
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Contact person for scientific queries
Name
94060
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Laurie Showler
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Address
94060
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Intensive Care Unit
Royal Melbourne Hospital
Level 5, B building
300 Grattan Street
Parkville VIC 3050
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Country
94060
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Australia
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Phone
94060
0
+61 416958489
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Fax
94060
0
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Email
94060
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
At the present time there is no intention to share IPD.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
2319
Ethical approval
377750-(Uploaded-12-06-2019-12-28-21)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF