Delirium research, education, and practice

Delirium research and clinical care has seen great strides in the last decade. Age and Ageing is making freely available an online collection of 15 papers published since 2012 which provides an overview of the range of research in delirium. It covers prevention and prediction, interventions and their health economic evaluations, outcomes following delirium, and clinical application in a review of the recent SIGN guidelines. The majority of studies took place in hospitals, but we also introduce some important research about another group at high risk of delirium: care home residents. We highlight the importance of delirium education. The studies comprised a range of methodologies (systematic reviews/meta-analysis, observational studies, trials and qualitative research). The selected papers are exemplars of work that has clear clinical implications.

Given that delirium affects 15-20% of hospital patients, studies or analysis of existing data with clinical relevance have the potential for enormous impact on practice and on more efficient use of healthcare resources. There is, however, still a great deal of work to be done to implement what is known to be effective, and so reduce the incidence of this distressing condition, and to support those affected: not only patients, but also families and carers, as well as staff in secondary and primary care, including care homes.

A full commentary on this collection has been published in the journal.

SUMMARY

1. The Scottish Intercollegiate Guidelines Network: risk reduction and management of delirium. Daniel Davis, Samuel D Searle, Alex Tsui

DELIRIUM PREVENTION

2. Preventing delirium: should non-pharmacological, multicomponent interventions be used? A systematic review and meta-analysis of the literature. Felipe Martinez, Catalina Tobar, Nathan Hill

3. Haloperidol versus placebo for delirium prevention in acutely hospitalised older at risk patients: a multi-centre double-blind randomised controlled clinical trial. Edmée J M Schrijver, Oscar J de Vries, et al.

4. Multicomponent delirium prevention: not as effective as NICE suggest? Elizabeth Teale, John Young

COST EFFECTIVENESS

5. Cost-effectiveness of multi-component interventions to prevent delirium in older people admitted to medical wards Anayo Akunne, Lakshmi Murthy, John Young

DELIRIUM PREDICTION

6. Risk factors for incident delirium among older people in acute hospital medical units: a systematic review and meta-analysis Suman Ahmed, Baptiste Leurent, Elizabeth L. Sampson

7. Delirium risk stratification in consecutive unselected admissions to acute medicine: validation of a susceptibility score based on factors identified externally in pooled data for use at entry to the acute care pathway. Sarah T. Pendlebury, Nicola G. Lovett, et al.

DELIRIUM DETECTION

8. Evaluation of delirium screening tools in geriatric medical inpatients: a diagnostic test accuracy study. Kirsty Hendry, Terence J. Quinn, et al.

9. Diagnostic test accuracy of informant-based tools to diagnose dementia in older hospital patients with delirium: a prospective cohort study. Thomas A. Jackson, Alasdair M. J. MacLullich, et al.

10. Nursing perspectives on the confusion assessment method: a qualitative focus group study Eric Kai-Chung Wong, Justin Yusen Lee, et al.

CARE HOMES

11. A prospective observational study to investigate utility of the Delirium Observational Screening Scale (DOSS) to detect delirium in care home residents E A Teale, T Munyombwe, et al.

DELIRIUM OUTCOMES

12. Partial and no recovery from delirium after hospital discharge predict increased adverse events. Martin G. Cole, Jane McCusker, et al.3

13. Undiagnosed long-term cognitive impairment in acutely hospitalised older medical patients with delirium: a prospective cohort study. Thomas A. Jackson, Alasdair M. J. MacLullich, et al.

EDUCATION

14. Increasing delirium skills at the front door: results from a repeated survey on delirium knowledge and attitudes. Rodric Peter Llewelyn Jenkin, Adam Al-Attar, et al.

15. Development of an international undergraduate curriculum for delirium using a modified delphi process. Claire Copeland, James Fisher, et al.

Browse the full library of themed collections on the Age and Ageing website.