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Critical IllnessICUconnect 2NCT06588556

Improving Needs Among Older Adults

A study testing ICUconnect in people with Critical Illness and Palliative Care, run by Duke University at 4 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Millions of older adults receive care in intensive care units (ICUs) annually. However, the quality and accessibility of ICU-based palliative care is highly variable across hospitals and clinicians, due in part to specialists' limited workforce and geographic inconsistency. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Critical Illness, Palliative Care, Older Adults
What is being tested?
ICUconnect
Could I receive a placebo?
No, everyone receives an active treatment
How many people
350 participants
Where
4 sitesUnited States
Study dates
16 Sep 2025to 31 Dec 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients (who are not interviewed but whose characteristics prompt enrollment of family members)
  • Adult aged ≥18 years
  • Managed in an adult medical, cardiac, trauma, surgical, or neurological ICU
  • Serious acute illness associated with a need for invasive mechanical ventilation
  • ICU team expect patient to require mechanical ventilation for 2 or more days
  • Family members
Show all 11Show fewer
  • Adult aged ≥18 years
  • Family member: self-described as the individual (related or unrelated) who provides the most support and with whom the eligible patient has a significant relationship (Society of Critical Care Medicine definition of family; Davidson J, et al. Crit Care Med, 45:103-128; 2017)
  • ICU clinicians
  • Adult aged ≥18 years
  • ICU clinician: ICU attending caring for the eligible patient on the day of family member informed consent

Who cannot join

  • Patients
  • Death or full comfort care plan expected within 24 hours by ICU attending or fellow physician Rationale: measurable intervention effect unlikely
  • Palliative care consultative team and/or palliative care specialists are currently involved in the patient's care.
  • Rationale: this would dilute the intervention's effect.
  • ICU length of stay >4 days during current ICU admission. Rationale: this would dilute intervention effect by widening the timeframe of family-clinician interactions and limiting standardization.
  • 6. Imprisoned person. Rationale: this is a vulnerable population.
Show all 15Show fewer
  • Family members
  • Low palliative care need burden (i.e., NEST scale score <15) at baseline. Rationale: if there are very low baseline needs, the intervention cannot impact the primary outcome measure (i.e., NEST).
  • Lack of English or Spanish fluency, operationalized as need for a translator to understand medical forms or participate in medical discussions.
  • Rationale: the app has not been translated into other languages; also, many outcome measures aren't validated in languages other than English and Spanish.
  • Endorsement of suicidal ideation (i.e., PHQ-9 suicidality item) at the time of baseline data collection.
  • Rationale: this indicates a serious level of distress that will require professional assistance beyond that provided by the intervention (or control).
  • Patient regains decisional capacity after informed consent but before the first family meeting. Rationale: as in our past ICU-based studies, this circumstance (the entry of the patient as a decision maker), would substantially change the nature of the interactions of family members and clinicians.
  • The ICU clinician changes from a consented clinician to a non-consented clinician before the first family meeting. Rationale: in this circumstance the intervention cannot be fully deployed.
  • ICU clinicians None

Trial locations and contacts

4 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Kristy Johnson contact

kristy.johnson@duke.edu

United States4 sites, 4 recruiting
  • University of Alabama-Birmingham

    Birmingham, Alabama, 35233

    Peter Morris

    Peter Morris

    Recruiting
  • Medical University of South Carolina

    Charleston, South Carolina, 29403

    Dee Ford

    Dee Ford

    Recruiting
  • Duke University Medical Center

    Durham, North Carolina, 27710

    Kristy J Johnson, 919-613-7321, kristy.johnson@duke.edu

    Christopher Cox, MD

    Recruiting
  • Columbia University

    New York, New York, 10032

    May Hua

    May Hua

    Recruiting

Other trials in United States

About this study

Official title: Improving Needs Among Older Adults: the ICUconnect 2 Primary Palliative Care RCT

Millions of older adults receive care in intensive care units (ICUs) annually. However, the quality and accessibility of ICU-based palliative care is highly variable across hospitals and clinicians, due in part to specialists' limited workforce and geographic inconsistency. To address these gaps, the investigators developed an innovative mobile app-based primary palliative care intervention called ICUconnect. ICUconnect facilitates families' and patients' self-report of actual palliative care needs across all core domains of palliative care quality, provides ICU clinicians with a scalable digital infrastructure for coordinating consistent and personalized needs-targeted care, and provides a variety of informational supports relevant to each user's role. In this RCT, the investigators will test ICUconnect vs. usual care control among 350 patient-family member dyads with elevated baseline levels of unmet palliative care need in a 4-site network serving a diverse population (Duke, Medical University of South Carolina, University of Alabama at Birmingham, Columbia).

The specific aims are to: (1) Test the efficacy of ICUconnect vs. usual care control in improving palliative care needs and other person-centered outcomes including psychological distress, (2) Determine participant characteristics associated with a greater treatment response using a heterogeneity of treatment effects approach, and (3) Ensure off-the-shelf intervention readiness for implementation using a mixed-methods integration of qualitative analysis of semi-structured trial participant interviews and quantitative RE-AIM implementation framework-informed trial data.

Read the detailed description

Millions of older adults receive care in intensive care units (ICUs) annually. However, the quality and accessibility of ICU-based palliative care is highly variable across hospitals and clinicians, due in part to specialists' limited workforce and geographic inconsistency. Furthermore, there are few evidence-based interventions designed to help ICU clinicians provide primary palliative care themselves-and even fewer interventions tested among participants who adequately reflect the racial and ethnic diversity of the US.

To address these gaps, the investigators developed an innovative mobile app-based primary palliative care intervention called ICUconnect. ICUconnect facilitates families' and patients' self-report of actual palliative care needs across all core domains of palliative care quality, provides ICU clinicians with a scalable digital infrastructure for coordinating consistent and personalized needs-targeted care, and provides a variety of informational supports relevant to each user's role. In a recent single-center cluster RCT with 111 patient-family member dyads (U54 MD012530), 42% of whom were Black, ICUconnect significantly improved unmet needs and goal concordance of care compared to usual care control. The investigators have since linguistically and culturally adapted the intervention to Latin American Spanish.

What is now needed is a multicenter RCT to test the intervention's efficacy in a population diverse in race, ethnicity, and geography that reflects the real-world experience of patients and family members. Therefore, the investigators will test ICUconnect vs. usual care control among 350 patient-family member dyads with elevated baseline levels of unmet palliative care need in a 4-site network serving a diverse population (Duke, Medical University of South Carolina, University of Alabama at Birmingham, Columbia).

The specific aims are to: (1) Test the efficacy of ICUconnect vs. usual care control in improving palliative care needs and other person-centered outcomes including psychological distress, (2) Determine participant characteristics associated with a greater treatment response using a heterogeneity of treatment effects approach, and (3) Ensure off-the-shelf intervention readiness for implementation using a mixed-methods integration of qualitative analysis of semi-structured trial participant interviews and quantitative RE-AIM implementation framework-informed trial data.

Being tested
ICUconnect, Usual care
Medical subject headings
Critical Illness

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ICUconnectBehavioural

    ICUconnect is essentially digital infrastructure for facilitating consistent person-centered communication. It is a web app platform that works on any digital device (smartphone, computer, tablet) and uses a series of automated and timed text messages and emails to direct family members and clinicians to perform timeline-driven tasks (e.g., surveys, content review, coaching features, family meetings) across the 7- to 10-day intervention period.

  • Usual careOther

    Control family participants will receive standard ICU care that includes the study team's suggestion to clinicians to conduct regular family meetings. While control participants will also report needs, all family meetings that occur, and other outcomes via texted or emailed links to surveys within the app platform, control group needs will not be visible to clinicians and ICUconnect content will not be visible to family members. However, basic study information and staff contacts will be available on a control group-specific website accessible via links sent by the platform at the time of each data collection.

Study groups in NCT06588556
Study groupRoleWhat they receive
ICUconnect interventionExperimentalICUconnect is essentially digital infrastructure for facilitating consistent person-centered communication. It is a web app platform that works on any digital device (smartphone, computer, tablet) and uses a series of automated and timed text messages and emails to direct family members and clinicians to perform timeline-driven tasks (e.g., surveys, content review, coaching features, family meetings) across the 7- to 10-day intervention period.
Receives: Behavioral: ICUconnect
Usual care controlOtherControl family participants will receive standard ICU care that includes the study team's suggestion to clinicians to conduct regular family meetings. While control participants will also report needs, all family meetings that occur, and other outcomes via texted or emailed links to surveys within the app platform, control group needs will not be visible to clinicians and ICUconnect content will not be visible to family members. However, basic study information and staff contacts will be available on a control group-specific website accessible via links sent by the platform at the time of each data collection.
Receives: Other: Usual care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Needs; Existential Concerns; Symptoms; and Therapeutic Interaction (NEST) Scale Total Score

    A palliative care needs instrument capturing all 8 domains of palliative care quality. Scores range from 0 (no needs) to 130 (higher needs).

    Measured: Time 1 (baseline), Time 2 (target ~3 days post-randomization), and Time 3 (target ~1 week post-randomization)

Secondary outcomes (6)
  1. Patient Health Questionnaire 9-Item scale (PHQ-9)

    A depression symptoms instrument. Scores range from 0 (no depression symptoms) to 27 (higher depression symptoms)

    Measured: Time 1 (baseline), Time 3 (target ~1 week post-randomization), and Time 4 (3 months post-randomization)

  2. Generalized Anxiety Disorder 7-Item scale (GAD-7)

    An anxiety symptoms instrument. Scores range from 0 (no anxiety symptoms) to 21 (higher anxiety symptoms)

    Measured: Time 1 (baseline), Time 3 (target ~1 week post-randomization), and Time 4 (3 months post-randomization)

  3. Post-Traumatic Stress Symptom (PTSS) inventory

    A post-traumatic stress disorder symptom instrument. Scores range from 10 (low PTSD symptoms) to 70 (higher PTSD symptoms)

    Measured: Time 1 (baseline) and Time 4 (3 months post-randomization)

  4. Goal concordant care

    A measure of hospital days after randomization

    Measured: Time 1 (baseline), Time 2 (target ~3 days post-randomization), and Time 3 (target ~1 week post-randomization)

  5. Patient-Perceived Patient-Centeredness (PPPC) scale

    A measure of patient-centeredness with scores that range from 12 (higher patient-centeredness) to 48 (lower patient-centeredness)

    Measured: Time 3 (target ~1 week post-randomization)

  6. Study impact as told in participants' own words

    qualitative analytic approach to a single prompt question with a response in either audio or text format from participant

    Measured: Study day 7

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Sep 2024
  2. Study start16 Sep 2025
  3. Primary completion31 Aug 2028 (estimated)
  4. Study completion31 Dec 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
350 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06588556
Sponsor's protocol ID
Pro00116128
Other IDs
R01AG084572
Acronym
ICUconnect 2
Status last verified
Jul 2026
First submitted
3 Sep 2024
Last updated
23 Jul 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Per NIH regulations

Publications

  • Cox CE, Ashana DC, Riley IL, Olsen MK, Casarett D, Haines KL, O'Keefe YA, Al-Hegelan M, Harrison RW, Naglee C, Katz JN, Yang H, Pratt EH, Gu J, Dempsey K, Docherty SL, Johnson KS. Mobile Application-Based Communication Facilitation Platform for Family Members of Critically Ill Patients: A Randomized Clinical Trial. JAMA Netw Open. 2024 Jan 2;7(1):e2349666. doi: 10.1001/jamanetworkopen.2023.49666.

    PubMed 38175648

Questions about this trial

What is this clinical trial studying?

A study testing ICUconnect in people with Critical Illness and Palliative Care, run by Duke University at 4 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 11 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 23 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Christopher Cox (919-684-8111, christopher.cox@duke.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Needs; Existential Concerns; Symptoms; and Therapeutic Interaction (NEST) Scale Total Score (time frame: Time 1 (baseline), Time 2 (target ~3 days post-randomization), and Time 3 (target ~1 week post-randomization)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06588556, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Jul 2026.

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Improving Needs Among Older Adults (NCT06588556) | AzTrials