Multicomponent, nonpharmacological delirium interventions for older inpatients : Ascoping review.

Claudia Eckstein,Heinrich Burkhardt

doi:10.1007/s00391-019-01627-y

Abstract

BackgroundOlder people represent a risk group for acquiring or further development of delirium during hospitalization, therefore requiring suitable nonpharmacological delirium interventions.ObjectiveThis scoping review analyzed nonpharmacological intervention programs for older inpatients with or without cognitive decline on regular or acute geriatric wards to present the range of interventions.MethodsA systematic literature search was conducted using scientific databases. A total of 4652 records were screened by two independent reviewers, leaving 81 eligible articles for full-text screening and 25 studies were finally included. Inclusion criteria were older patients ≥65 years in regular or acute geriatric wards and nonpharmacological multicomponent interventions.ResultsMore than a half of the included studies (14, 56%) recruited patients with pre-existing cognitive decline as part of the study population and 12% focused exclusively on patients with cognitive decline. On average 11 intervention components were integrated in the programs and two programs included full coverage of all 18 identified components.ConclusionOnly few programs were described for older inpatients and even fewer regarding pre-existing cognitive decline. The low numbers of interventions and data heterogeneity restricted the assessment of outcomes; however, delirium incidence, as reported by two thirds of the studies was reduced by nonpharmacological multicomponent interventions.Electronic supplementary materialThe online version of this article (10.1007/s00391-019-01627-y) contains supplementary material, which is available to authorized users.

Highlights

Delirium frequently occurs in older inpatients and constitutes a major and serious complication in acute care
These programs disclosed a limited range of interventions; professional expertise is required to ensure a more comprehensive delirium prevention and to address delirium management and treatment. This scoping focused on interventional programs provided by ward team professionals. These programs refer to the target group of older and endangered patients, but current evidence does not conclusively clarify whether this applies to persons with cognitive decline, especially in the acute care setting [20, 21]
This review provides an overview of nonpharmacological delirium intervention programs for older inpatients with and

Summary

Introduction

Delirium frequently occurs in older inpatients and constitutes a major and serious complication in acute care. These programs disclosed a limited range of interventions; professional expertise is required to ensure a more comprehensive delirium prevention and to address delirium management and treatment For this reason, this scoping focused on interventional programs provided by ward team professionals. This scoping focused on interventional programs provided by ward team professionals These programs refer to the target group of older and endangered patients, but current evidence does not conclusively clarify whether this applies to persons with cognitive decline, especially in the acute care setting [20, 21]. This scoping review analyzed nonpharmacological intervention programs for older inpatients with or without cognitive decline on regular or acute geriatric wards to present the range of interventions. The low numbers of interventions and data heterogeneity restricted the assessment of outcomes; delirium incidence, as reported by two thirds of the studies was reduced by nonpharmacological multicomponent interventions

Methods

Results

Discussion

Conclusion