DEL-FINE: a new tool for assessing the delirogenic properties of drugs of relevance for European pharmacotherapy.
This article presents a list of potentially delirogenic properties of drugs that are currently of relevance to drug therapy in Europe, which was created through a Delphi process including experts from professions relevant to diagnosis and treatment of delirium. The Diagnostic and Statistical Manual of Mental Disorders 5 (DSM 5) defines delirium as a disturbance in attention, awareness and cognition that develops over a short period of time and fluctuates. Possible causes of delirium are manifold: usually delirium is considered to develop in a multifactorial way, caused by inalterable parameters, such as advanced age and pre-existing cognitive impairment and precipitated by modifiable parameters, such as the use of certain drugs or substance withdrawal. Delirium is a serious condition with a pronounced impact on morbidity, mortality and costs to the healthcare system. Circumstances and drugs that might precipitate or worsen delirium should therefore be avoided whenever possible. A list of drugs that might have a detrimental influence on the emergence and duration of delirium has been created using the terms "delirogenity" and "delirogenic" to describe the potential of a drug or withdrawal to cause or worsen delirium. The results are novel and noteworthy, as their focus is on substances relevant to European pharmacotherapy. Furthermore, they represent a methodical consensus from a group of experts of a wide variety of professions relevant to the prevention, diagnosis and treatment of delirium, such as nursing, pharmacy, pharmacology, surgical and internal medicine, neurology, psychiatry, intensive care and medicine, with working, teaching and scientific experience in several European countries practicing both in primary and secondary care.
Department of Geriatric Medicine, Paracelsus Medical University, Ignaz-Harrer-Straße 79, 5020, Salzburg, Austria. birgit.boehmdorfer@stud.pmu.ac.at.|Pharmacy Department, Hospital Hietzing with Neurological Centre Rosenhügel, Wolkersbergenstrasse 1, 1130, Vienna, Austria. birgit.boehmdorfer@stud.pmu.ac.at.
Birgit
B
Böhmdorfer
, Nußdorferstraße 55/21, 1090, Vienna, Austria.
Sonja
S
Rohleder
Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, Sasinkova 4, 811 08, Bratislava, Slovakia.
Martin
M
Wawruch
Section of Geriatric Medicine, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.|Department of Medicine, Brighton and Sussex Medical School, Brighton, UK.|Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands.
T J M
TJ
van der Cammen
Department of Geriatric Acute Care, Hospital Hietzing with Neurological Centre Rosenhügel, Wolkersbergenstrasse 1, 1130, Vienna, Austria.
Thomas
T
Frühwald
Department of Psychiatry and Psychotherapy of Old Age, Landeskrankenhaus Graz Süd-West, Wagner -Jauregg - Platz 1, 8053, Graz, Austria.
Christian
C
Jagsch
Pharmacy Department, Hospital Hietzing with Neurological Centre Rosenhügel, Wolkersbergenstrasse 1, 1130, Vienna, Austria.
Susanne Melitta Maria
SM
Janowitz
Pharmacy Department, SMZ-Ost/Donauspital, Langobardenstraße 122, 1220, Vienna, Austria.
Marietta
M
Nagano
Department of Geriatrics, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
Mirko
M
Petrovic
Department of Geriatric Acute Care, Hospital Hietzing with Neurological Centre Rosenhügel, Wolkersbergenstrasse 1, 1130, Vienna, Austria.
Ulrike
U
Sommeregger
Department of Geriatric Medicine, Paracelsus Medical University, Ignaz-Harrer-Straße 79, 5020, Salzburg, Austria.
Bernhard
B
Iglseder
D064807:Anticholinergic Syndrome / Q000209:etiology*; D003693:Delirium / Q000139:chemically induced*; D003697:Delphi Technique; D004358:Drug Therapy / Q000592:standards*; D005060:Europe; D005104:Expert Testimony / Q000379:methods / Q000592:standards*; D006801:Humans; D017410:Practice Guidelines as Topic
Anticholinergic properties; Delirium; Drugs; Pharmacotherapy; Substance withdrawal