Non clinic-Based Interventions to Mitigate Post-Intensive Care Syndrome: A Scoping Review

OBJECTIVES: Survivors of critical illness and their caregivers often experience a complex constellation of sequelae in the aftermath of their recovery, termed post-intensive care syndrome (PICS) and PICS-Family (PICS-F), respectively. These can have a dire impact on patients and families, and thus require coordinated rehabilitative efforts. However, optimal modes of providing support services remain unclear, with traditional clinic-based strategies showing mixed results. This scoping review aimed to summarize the feasibility and effectiveness of nonclinic-based follow-up and rehabilitation strategies for adult survivors of critical illness and their caregivers. DATA SOURCES: Databases were searched on July 8, 2025, and included Cochrane, Embase, PubMed, and Web of Science. STUDY SELECTION: Studies reporting interventions and follow-up options for adult survivors of critical illness requiring ICU stay and targeting PICS and PICS-F were included. Studies examining interventions in the outpatient clinic or ICU settings exclusively were excluded. DATA EXTRACTION: Two team members used Covidence to screen all the deduplicated citations, with a third team member acting as a tiebreaker. The studies included were reviewed in full to extract general data, the studied syndrome (PICS, PICS-F, or both), component of PICS studied, study population, study objectives, methods, inclusion and exclusion criteria, intervention details, general results, and study conclusions. DATA SYNTHESIS: We screened 8608 studies; 45 studies met criteria and were included in this review. Most (64%) focused on the physical and psychological sequelae of PICS. Interventions varied widely, by setting, duration, and approach. Outcome measures were heterogeneous, limiting comparisons. Most studies evaluated the feasibility of interventions and not effectiveness. Only six articles targeted PICS-F exclusively. CONCLUSIONS: This scoping review summarizes the status of different nonclinic-based follow-up and rehabilitation strategies for adult ICU survivors. Future research focused on studies that evaluate effectiveness of these strategies in mitigating the burden of PICS and PICS-F, especially within the cognitive domain, is likely to improve aftercare for both patients and their families.