Non-pharmacological interventions in the prevention of delirium.
Delirium is a serious and common disorder especially among older people on inpatients units. Numerous modifiable or manageable delirium risk factors have been identified. As a result, there is now a widespread notion that many cases of delirium can be prevented. In this review, published data evaluating non-pharmacological interventions for delirium prevention were assessed in relation to their efficacy. Currently, most published studies are based on direct targeting of risk factors and/or introduction of educational programmes to increase staff knowledge and awareness. However, there continues to be a dearth of randomised controlled trials evaluating non-pharmacological interventions, partly because of the inherent difficulties associated with delirium research in general and with the evaluation of non-pharmacological interventions in particular. Instead, many of the available studies have been observational or non-randomised in nature. Nevertheless, the majority of these support a role for non-pharmacological interventions in delirium prevention. While more research is certainly needed, the majority of available data are based on best practice protocols, guidelines and interventions. Hence, a consistent and concerted effort is now justified to introduce non-pharmacological prevention strategies across units to help tackle the increasingly prevalent delirium among older people.
Tabet
Naji
N
Institute of Postgraduate Medicine, Brighton & Sussex Medical School, University of Brighton, Falmer, Brighton, UK. n.t.tabet@brighton.ac.uk
Howard
Robert
R
D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000193:education*; D002986:Clinical Trials as Topic; D003693:Delirium / Q000517:prevention & control*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors