Specialty experience in geriatric medicine is associated with a small increase in knowledge of delirium

R P L Jenkin,A M J Maclullich,D H J Davis,P Musonda,P K Myint

doi:10.1093/ageing/aft159

Abstract

Background: delirium is underdiagnosed and undertreated. Understanding of delirium among doctors in medical and ICU settings has previously been shown to be low. We hypothesised that junior doctors who had gained experience in geriatrics, neurology or psychiatry may have an increased knowledge of delirium.Methods: we used data from a large multi-centre study of junior doctors conducted between December 2006 and January 2007 which is, to date, the largest survey of understanding of delirium among junior doctors. The original survey used a questionnaire within which certain key items led to a correct or incorrect answer. Total correct answers were recorded giving a maximum total knowledge score of 17 for each participant. The relationship between total knowledge score achieved on the questionnaire and time since qualification; specialty experience in geriatric medicine, psychiatry and/or neurology and self-reported experience with the Confusion Assessment Method (independent variables) were modelled using linear regression.Results: around half (53.2%; 399 of 750) of those surveyed stated that they had experience in geriatric medicine. In contrast only 4.1 and 8.0% of respondents had experience in psychiatry and neurology, respectively. Experience in geriatric medicine was significantly associated with a modest increase in correct answers (4.7 versus 4.3 points, P = 0.020). No other variables were significantly associated with better scores.Conclusion: experience in geriatric medicine leads to a small improvement in understanding of delirium among junior doctors.

Highlights

Delirium is an acute neuropsychiatric syndrome, occurring in 11–42% of elderly in-patients [1]
Around half (53.2%; 399 of 750) of those surveyed stated that they had experience in geriatric medicine
Experience in geriatric medicine was significantly associated with a modest increase in correct answers (4.7 versus 4.3 points, P = 0.020)

Summary

Introduction

Delirium is an acute neuropsychiatric syndrome, occurring in 11–42% of elderly in-patients [1]. The presence of delirium is associated with prolonged hospital stay, higher rates of institutionalisation and increased mortality [2]. Despite its high prevalence and major clinical significance, delirium is consistently under-recognised [1, 5]. Previous studies have examined doctors’ understanding of delirium in the medical inpatient and ICU settings [6,7,8]. These studies have shown that the understanding of delirium appears to be poor in comparison with other common medical conditions such as acute coronary syndrome or pneumonia. There is a consistent discrepancy between participants’ perception of the importance of delirium and their understanding of delirium; while the respondents acknowledged delirium is highly prevalent and important, they lacked understanding and were unfamiliar with delirium assessment tools

Methods

Results

Conclusion