Preventing delirium in an acute hospital using a non-pharmacological intervention.

Abstract

BACKGROUND: delirium is a clinical syndrome associated with multiple short and long-term complications and therefore prevention is an essential part of its management. This study was designed to assess the efficacy of multicomponent intervention in delirium prevention.

METHODS: a total of 287 hospitalised patients at intermediate or high risk of developing delirium were randomised to receive a non-pharmacological intervention delivered by family members (144 patients) or standard management (143 patients). The primary efficacy outcome was the occurrence of delirium at any time during the course of hospitalisation. Three validated observers performed the event adjudication by using the confusion assessment method screening instrument.

RESULTS: there were no significant differences in the baseline characteristics between the two groups. The primary outcome occurred in 5.6% of the patients in the intervention group and in 13.3% of the patients in the control group (relative risk: 0.41; confidence interval: 0.19-0.92; P = 0.027).

CONCLUSION: the results of this study show that there is a benefit in the non-pharmacological prevention of delirium using family members, when compared with standard management of patients at risk of developing this condition.