Effects of a brief primary care intervention for post-traumatic stress disorder symptoms after critical illness on health-related quality of life - A secondary analysis of the PICTURE randomised controlled trial
In brief
GP-delivered narrative exposure adds 6-point quality-of-life gain at six months
In a trial of 319 ICU survivors with moderate PTSD symptoms, a brief general-practice narrative exposure session produced a modest but clinically meaningful rise of about 6 points on the EQ visual analog scale at six months and a smaller improvement in the overall health index by twelve months.
- Journal
- The European journal of general practice (Q1)
- Published
- 21 July 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Robert Philipp Kosilek, Nora Schröder, Linda Sanftenberg, Caroline Jung-Sievers, Daniela Lindemann, Antina Beutel, et al.
- PMID
- 42480006
- DOI
- 10.1080/13814788.2026.2702686
Why clinicians should know about it
- Picked for Critical Care and Intensive Care Medicine (paper of the day, 22 July 2026): Post‑ICU PTSD brief intervention RCT
Abstract
BACKGROUND: Intensive care unit (ICU) survivors frequently experience symptoms of post-traumatic stress disorder (PTSD) and reduced health-related quality of life (HRQoL), yet evidence for effective post-ICU interventions in primary care remains limited. This secondary analysis of the PICTURE randomised controlled trial provides an in-depth evaluation of HRQoL trajectories and potential treatment mechanisms. METHODS: The analysis included 319 adult ICU survivors with at least moderate PTSD symptoms, randomised to a brief general practitioner (GP)-delivered narrative exposure intervention or enhanced usual care. Longitudinal mixed-effects models estimated treatment-by-time effects on HRQoL, based on EuroQol Five-Dimension Five-Level (EQ-5D-5L) index and visual analog scale (VAS), with mediation via PTSD symptom change assessed using structural equation modelling. RESULTS: The mean baseline EQ index was 0.71 ± 0.27 and EQ VAS was 60.7 ± 19.4. Mixed-effects models showed a transient improvement in EQ VAS at 6 months in the intervention group (ß = 5.85; 95% CI 0.84-10.87), followed by a delayed improvement in the EQ index at 12 months (ß = 0.075; 95% CI 0.014-0.136). About one quarter of the 12-month EQ index effect was mediated by PTSD symptom reduction at 6 months. Domain-level analyses indicated greater improvement in anxiety/depression and mobility. CONCLUSIONS: In ICU survivors with PTSD symptoms, a brief GP-delivered psychological intervention was associated with clinically meaningful improvements in health-related quality of life over 12 months, with effects emerging over time and only partly explained by PTSD symptom reduction. TRIAL REGISTRATION: ClinTrials.gov: NCT03315390 (Registration date: 2017-10-20); German Clinical Trials Register (DRKS): DRKS00012589 (Registration date: 2017-10-17).
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.