Impact of an educational workshop upon attitudes towards pharmacotherapy for delirium.
BACKGROUND
There is uncertainty regarding the optimal use of pharmacological strategies in delirium particularly regarding preferred agents, duration of treatment and effectiveness in different populations.


METHODS
Attitudes towards delirium pharmacotherapy were investigated before and after an educational workshop using the format of a television game show.


RESULTS
Most respondents (65/66) reported psychotropic use with variable frequency (median 60%). Antipsychotic use was inversely related to perception of supporting evidence (p = 0.02). Respondents rated sedative (38%) and antipsychotic (33%) effects as the principal mechanism of action rather than a specific neurochemical anti-delirium effect (21%). Haloperidol was the preferred first-line agent (65%). Suggested continuation treatment after symptom resolution was three days. Eleven respondents had used psychotropics prophylactically. Antipsychotic use was influenced by concerns regarding potential for extrapyramidal (52%), sedative (32%), cerebrovascular (30%) and metabolic (8%) effects. Post-workshop concerns regarding extrapyramidal effects were reduced with a more positive general attitude towards pharmacological interventions, especially in hypoactive presentations (61%) and prophylactically in high-risk patients (56%).


CONCLUSIONS
Attitudes towards key aspects of delirium pharmacotherapy vary considerably and relate to concerns regarding side effect potential more than perceived mechanism of action. Educational interventions can impact positively upon attitudes.
Meagher
David J
DJ
Department of Adult Psychiatry, Midwestern Regional Hospital, Limerick, Ireland. david.meagher@ul.ie
D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D003479:Curriculum; D003693:Delirium / Q000188:drug therapy*; D064420:Drug-Related Side Effects and Adverse Reactions; D004493:Education; D019317:Evidence-Based Medicine; D005852:Geriatric Psychiatry / Q000193:education*; D006801:Humans; D010818:Practice Patterns, Physicians'; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D006113:United Kingdom
D014150:Antipsychotic Agents; D011619:Psychotropic Drugs