PICOS App

The PICOS App

Digital support in post-ICU care

After a stay in an intensive care unit, many patients frequently experience mental and physical symptoms such as concentration problems or muscle weakness. Such symptom patterns are grouped under “Post Intensive Care Syndrome” (PICS). In addition to possible limitations in quality of life, long-term inpatient treatment and outpatient follow-up care may be required.

The DISTANCE project, funded until September 2025 by the Federal Ministry of Research, Technology and Space, aimed to improve aftercare following an intensive care stay. As part of DISTANCE, the PICOS Study was conducted to research the physical and mental effects of an ICU stay and to develop improved treatment options. More than 200 former intensive care patients from nine regional healthcare facilities documented their physical and mental symptoms for one year after their ICU stay, in order to enable better treatment for themselves and for future patients.

Grafische Darstellung einer Hand, die ein Smartphone mit der PICOS-App zur Intensivnachsorge hält.

How patients benefited from the PICOS Study

With the PICOS App, they were able to document their physical and mental condition, e.g., sleep duration and quality, physical activity, or blood pressure.

The PICOS App provided them with a long-term overview of the development of their health status.

They could use the app as a planner for taking medication, doctor’s appointments, and other therapeutic measures.

As part of follow-up examinations, they regularly had the opportunity to speak directly with a physician.

The PICOS App: support for everyday self-care

The PICOS App accompanied former intensive care patients in their recovery process after hospital discharge. By regularly entering information about their physical and mental well-being into the app, they received a comprehensive overview of their individual health status. In addition, four follow-up examinations were conducted during the study to gather further information on their health.

Future patients can also benefit from the PICOS Study: use of the app generated data that helps advance the development of new treatment and therapy options for intensive care patients. These data were encrypted and made available to medical researchers in compliance with applicable data protection regulations.

Patients were able to use the PICOS App once a study assistant had informed them about it and set up the mobile application on their smartphone.

Picture: © istockphoto.com/Ridofranz 121450916 | Video: © UK RWTH Aachen

This is how the PICOS study was conducted:

1. Eligibility:

First, it was assessed whether former intensive care patients were eligible to participate in the PICOS study. They qualified if they were over 18 years old and had either been mechanically ventilated for at least 24 hours or had spent at least 72 hours in the ICU.

2. Patient briefing:

: If patients were eligible, a study assistant informed and educated them about the process and framework of the PICOS Study. At this point, they could consent to participate.

3. Declaration of consent:

If patients agreed to participate, they signed an informed consent form. This could be withdrawn at any time without stating reasons.

4. Installation and activation of the PICOS Application:

The PICOS App was installed on the patients’ smartphones either by themselves or by a study assistant. They then automatically received the login data for activating the app by email.

5. Enter data:

Additional data such as laboratory values or medications received in the ICU were entered into the PICOS App by the study assistants. After being discharged from the hospital, patients were able to use the app from home to document their health status. Entering vital signs daily was recommended to obtain a comprehensive overview of their own health.

6. Follow-up examinations:

Follow-ups were conducted in the hospital and after three, six, and twelve months. The physical and mental health status of participants was assessed holistically.

The following tests will be performed:

Blood pressure and heart rate measurement, ECG, Two-minute walk test, Tests to assess cognitive performance and quality of life

7. Other questions:

Do you have questions about the PICOS Study? Contact our study assistance. They will be happy to help you!

Patients’ needs were taken into account

Patients who experience physical and mental symptoms after an ICU stay have specific needs when using a health app. To ensure that the PICOS App would meet these needs, a preliminary study surveyed 123 intensive care patients about their wishes and expectations for the app.

The initial feedback was consistently positive. Patients regarded the app as a valuable self-management tool that increased their involvement in their own healthcare. Based on the findings of this preliminary study and further user surveys, the PICOS App was further developed both in terms of content and technology.

PICOS-App | Informations for Patients

Status: 04/2024

PICOS-App | Informations for Patients (German)

German Sepsis Help e. V. represents patients in DISTANCE

To ensure that the needs of patients were addressed beyond the study phase, the German Sepsis Help e. V. (Deutsche Sepsis-Hilfe e. V.) supported the DISTANCE project as a patient organization. With over 350 members, the association advocates for the interests of people affected by sepsis and their relatives.

Sepsis is an excessive or insufficient immune response to an infection that can lead to life-threatening organ failure. Causes may include bacteria, viruses, or contaminated open wounds, which is why sepsis can especially occur during a hospital stay. People with sepsis often require treatment in an intensive care unit. Representatives of the German Sepsis Aid Association advised the DISTANCE project on developing the PICOS App and promoted its use within the organization.