biostudies-literatureUnknown16(2)Mentzelopoulos SD<h4>Introduction</h4>Patients in intensive care units (ICUs) and their families face existential physical, psychosocial and spiritual distress. Integrating palliative care (PC) into ICU care may benefit patients, relatives and ICU clinicians. Prior PC studies have shown a reduction in ICU length of stay (LOS) and distressing symptoms without altering overall mortality. A shorter ICU LOS may alleviate the burden for patients and relatives and help optimise the use of limited intensive care resources. PC in the ICU, however, remains underused, partly due to limited access and knowledge of ICU clinicians. Also, robust data regarding the effectiveness and cost-effectiveness of PC treatment in the ICU are scarce. We established the 'enhancing palliative care in ICUs' (EPIC) study to implement aBMJ opene108168https://www.ebi.ac.uk/biostudies/studies/S-EPMC12918684biostudies-literatureEnhancing palliative care in intensive care units: protocol of EPIC, a controlled, cluster-randomised, non-blinded stepped-wedge design trial with crossover phase.PMC12918684Dutzmann JDe Robertis EMentzelopoulos SDDrescher DSpies CHartog CSSchwenkglenks MEdel ATenge Tvan Heerden VNeukirchen MJensen HISchuurhuis SMetaxa VNachshon AZvara MPiper SKRusinova KBarbier MfalseEnhancing palliative care in intensive care units: protocol of EPIC, a controlled, cluster-randomised, non-blinded stepped-wedge design trial with crossover phase.<h4>Introduction</h4>Patients in intensive care units (ICUs) and their families face existential physical, psychosocial and spiritual distress. Integrating palliative care (PC) into ICU care may benefit patients, relatives and ICU clinicians. Prior PC studies have shown a reduction in ICU length of stay (LOS) and distressing symptoms without altering overall mortality. A shorter ICU LOS may alleviate the burden for patients and relatives and help optimise the use of limited intensive care resources. PC in the ICU, however, remains underused, partly due to limited access and knowledge of ICU clinicians. Also, robust data regarding the effectiveness and cost-effectiveness of PC treatment in the ICU are scarce. We established the 'enhancing palliative care in ICUs' (EPIC) study to implement a2026-01-01T00:00:00Z2026 Feb2026-07-16T09:59:24.303Z2026-07-09T10:49:54.785ZS-EPMC129186844170266010.1136/bmjopen-2025-108168