Post-traumatic stress disorder - are we doing all we can? A UK national-based survey

Introduction

Post-traumatic stress disorder (PTSD) is a well-recognised complication in patients discharged from the ICU. ICU clinics have been recommended to treat physical and psychosocial problems post discharge, with guidelines issued by the Department of Health UK [1]. Recent evidence has advocated the use of patient diaries to reduce the incidence of new-onset PTSD [2]. Family support groups may also play a pivotal role [3]. We performed a national survey via the Intensive Care Society (ICS) to determine the provision of follow-up clinics, patient diary services and family support groups.

Methods

An online structured questionnaire was sent via the ICS to all ICU linkmen at 124 hospitals in the UK. Responses were received from 77 ICUs, a 62% response rate.

Results

Out of 77 ICUs, 37 (48%) run a follow-up clinic. The majority of clinics (51%) only invite patients who have been admitted for more than 3 to 4 days. Only 10 clinics (30%) receive funding from the ICU budget or PCT, with the majority (67%) receiving no funding at all. Only 44% (34) of ICUs use patient diaries, mostly as a nonfunded service (68%). Additionally, 91% of ICUs do not run family support groups; from the minority that do, these are mostly held quarterly and are largely not funded (55%).

Conclusion

This survey demonstrates that the provision of ICU clinics in the UK is not well established, with only 48% currently providing a regular service. Currently 67% of clinics are not funded and further resources should be employed so this service becomes an integral part of the ICU pathway. Despite recent evidence demonstrating that diaries reduce new-onset PTSD, only 44% of ICUs in our study provide this service. Ninety-one per cent of ICUs do not provide family support groups; similarly, it appears that financial constraints are the limiting factor.