Prevention, diagnosis and treatment of delirium: Staff educational approaches

Expert Review of Neurotherapeutics

Volumn 6, Issue 5, 2006, Pages 741-751

  Tabet, Naji ^a   Howard, Robert ^b  

^a UNIVERSITY OF BRIGHTON   (United Kingdom)

^b KING'S COLLEGE LONDON   (United Kingdom)

Author keywords

Delirium; Diagnosis; Education; Intervention; Prevention; Treatment

Indexed keywords

AMISULPRIDE; DONEPEZIL; HALOPERIDOL; OLANZAPINE; QUETIAPINE; RISPERIDONE; RIVASTIGMINE;

CLINICAL TRIAL; DELIRIUM; HUMAN; MEDICAL EDUCATION; MEDICAL STAFF; MORBIDITY; MORTALITY; NURSING EDUCATION; REVIEW; RISK FACTOR; SYMPTOMATOLOGY; EDUCATION; PREVENTIVE MEDICINE;

DELIRIUM; EDUCATION, MEDICAL; EDUCATION, NURSING; HUMANS; MEDICAL STAFF, HOSPITAL; PREVENTIVE MEDICINE;

EID: 33745057473     PISSN: 14737175     EISSN: 17448360     Source Type: Journal    
DOI: 10.1586/14737175.6.5.741     Document Type: Review

References (100)

1. Rockwood K, Lindesay J. The concept of delirium: historical antecedents and present meanings. In: Delirium in Old Age. Lindesay J, Rockwood K, Macdonald A (Eds), Oxford University Press, Oxford, UK, 1-8 (2002).
2. Caraceni A, Grassi L. Delirium: historical concepts and current definitions. In: Delirium: Acute Confusional States in Palliative Medicine. Caraceni A, Grassi L (Eds), Oxford University Press, Oxford, UK, 1-20 (2003).
3. Packard RC. Delirium. Neurologist 7, 327-340 (2001).
4. WHO. The ICD-10. Classification of mental and behavioural disorders: diagnostic criteria for research. Geneva: WHO (1993).
5. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Washington, DC, USA (1994).
6. O'Keeffe S. The prevention of delirium. In: Delirium in Old Age. Lindesay J, Rockwood K, Macdonald A (Eds), Oxford University Press, Oxford, UK, 153-185 (2002).
7. Cole MG, McCusker J, Bellavance F et al. Systematic detection and multidisciplinary care of delirium in older medical inpatients: a randomised trial. Can. Med. Assoc. J. 167, 753-759 (2002).
8. Young LJ, George J. Do guidelines improve the process and outcomes of care in delirium? Age Ageing 32, 525-528 (2003).
9. Korevaar JC, van Munster BC, de Rooij SE. Risk factors for delirium in acutely admitted elderly patients: a prospective cohort study. BMC Geriatr. 5, 1-8 (2005).
10. Sherman FT. Delirium. More common than stroke; it befuddles both clinicians and seniors. Geriatrics 57, 5-6 (2002).
11. Minden SL, Carbone LA, Barsky A et al. Predictors and outcomes of delirium. Gen. Hosp. Psychiatry 27, 209-214 (2005).
12. McCarthy MC. Detecting acute confusion in older adults: comparing clinical reasoning of nurses working in acute, long-term, and community health care environments. Res. Nurs. Health 26, 203-212 (2003).
13. Bekker AY, Weeks EJ. Cognitive function after anaesthesia in the elderly. Best Pract. Res. Clin. Anaesthesiol. 17, 259-272 (2003).
14. Bitsch MS, Foss NB, Kristensen BB, Kehlet H. Pathogenesis of and management strategies for postoperative delirium after hip fracture: a review. Acta. Orthop. Scand. 75, 378-389 (2004).
15. Fann JE. The epidemiology of delirium: a review of studies and methodological issues. Semin. Clin. Neuropsych. 5, 64-74 (2000).
16. Laurila JV, Pitkala KH, Strandberg TE, Tilvis RS. The impact of different diagnostic criteria on prevalence rates for delirium. Dement. Geriatr. Cogn. Disord. 16, 156-162 (2003).
17. Folstein MF, Bassett SS, Romanoski AJ, Nestadt G. The epidemiology of delirium in the community: the Eastern Baltimore Mental Health Survey. Int. Psychogeriatr. 3, 169-176 (1991).
18. Inouye SK, Schlesinger MJ, Lyndon TJ. Delirium: a symptom of how hospital care is failing older persons and a window to improve quality of hospital care. Am. J. Med. 106, 565-573 (1999).
19. Leslie DL, Zhang Y, Holford TR, Bogardus ST, Leo-Summers LS, Inouye SK. Premature death associated with delirium at 1-year follow up. Arch. Intern. Med. 165, 1657-1662 (2005).
20. Kulh MA, Mumford VA, Sorensen R, Budge MM. Management of delirium: a clinical governance approach. Aust. Health Rev. 29, 246-252 (2005).
21. Meagher DJ. Delirium: optimising management. Br. Med. J. 322, 144-149 (2001).
22. Samuels SC, Evers MM. Pragmatic guidance for managing a common, confounding, and sometimes lethal condition. Geriatrics 57, 33-38 (2002).
23. Kales HC, Kamholz BA, Visnic SG, Blow FC. Recorded delirium in a national sample of elderly inpatients: potential implications for recognition. J. Geriatr. Psych. Neurol. 16, 32-38 (2003).
24. Rabinowitz T. Delirium: an important (but often unrecognized) clinical syndrome. Curr. Psych. Rep. 4, 202-208 (2002).
25. Andrew MK, Freter SH, Rockwood K. Incomplete functional recovery after delirium in elderly people: a prospective cohort study. BMC Geriatr. 5, 5 (2005).
26. Duppils GS, Wikblad K. Delirium: behavioural changes before and during the prodromal phase. J. Clin. Nurs. 13, 609-616 (2004).
27. Cole M, McCusker J, Dendukuri N, Han L. The prognostic significance of subsyndromal delirium in elderly medical inpatients. J. Am. Geriatr. Soc. 51, 754-760 (2003).
28. Caraceni A, Grassi L. Delirium: historical concepts and current definitions. In: Delirium: Acute Confusional States in Palliative Medicine. Caraceni A, Grassi L (Eds), Oxford University Press, Oxford, UK, 42-60 (2003).
29. Greenberg DB. Preventing delirium at the end of life: lessons from recent research. Prim. Care Companion J. Clin. Psych. 5, 62-67 (2003).
30. Cole M, McCusker J, Dendukuri N, Han L. Symptoms of delirium among elderly medical inpatients with or without dementia. J. Neuropsych. Clin. Neurosci. 14, 167-175 (2002).
31. Evans LK. Sundown syndrome in institutionalized elderly. J. Am. Geriatr. Soc. 35, 101-108 (1987).
32. Wallesch CW, Hundsalz A. Language function in delirium: a comparison of single word processing in acute confusional states and probable Alzheimer's disease. Brain Lang. 46, 592-606 (1994).
33. Aakerlund LP, Rosenberg J. Writing disturbances: an indicator for postoperative delirium. Int. J. Psych. Med. 24, 245-257 (1994).
34. Baranowski SL, Patten SB. The predictive value of dysgraphia and constructional apraxia for delirium in psychiatric inpatients. Can. J. Psych. 45, 75-78 (2000).
35. Lindesay J, Rockwood K, Rolfson D. The epidemiology of delirium. In: Delirium in Old Age. Lindesay J, Rockwood K, Macdonald A (Eds), Oxford University Press, Oxford, UK, 27-50 (2002).
36. de Rooij SE, Schuurmans MJ, van der Mast RC, Levi M. Clinical subtypes of delirium and their relevance for daily clinical practice: a systemic review. Int. J. Geriatr. Psych. 20, 609-615 (2005).
37. Spiller JA, Keen JC. Hypoactive delirium: assessing the extent of the problem for inpatient specialist palliative care. Palliat. Med. 20, 17-23 (2006).
38. Marcantonio E, Ta T, Duthie E, Resnick NM. Delirium severity and psychomotor types: their relationship with outcomes after hip fracture repair. JAGS 50, 850-857 (2002).
39. Santos FS, Wahlund LO, Varli F, Velasco IT, Jonhagen ME. Incidence, clinical features and subtypes of delirium in elderly patients treated for hip fractures. Dement. Geriatr. Cogn. Disord. 20, 231-237 (2005).
40. Misra S, Ganzini L. Delirium, depression, and anxiety. Crit. Care Clin. 19, 771-787 (2003).
41. Charlton BG, Kavanau JL. Delirium and psychotic symptoms: an integrative model. Med. Hypotheses 58, 24-27 (2002).
42. Tabet N, Hudson S, Sweeney V et al. An educational intervention can prevent delirium on acute medical wards. Age Ageing 34, 152-156 (2005).
43. Rockwood K, Cosway S, Stolee P et al. Increasing the recognition of delirium in elderly patients. J. Am. Geriatr. Soc. 42, 252-256 (1994).
44. Caraceni A and Grassi L. Diagnostic assessment. In: Delirium: Acute Confusional States in Palliative Medicine. Caraceni A, Grassi L (Eds), Oxford University Press, Oxford, UK, 119-130 (2003).
45. Robertsson B. The instrumentation of delirium. In: Delirium in Old Age. Lindesay J, Rockwood K, Macdonald A (Eds), Oxford University Press, Oxford, UK, 9-25 (2002).
46. Cole MG, Dendukuri N, McCusker J, Han L. An empirical study of different diagnostic criteria for delirium among elderly medical inpatients. J. Neuropsych. Clin. Neurosci. 15, 200-207 (2003).
47. Trzepacz PT, Baker RW, Greenhouse J. A symptom rating scale for delirium. Psychiatry Res. 23, 89-97 (1988).
48. Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the confusion assessment method. A new method for detectionof delirium. Ann. Intern. Med. 113, 941-948 (1990).
49. Laurila JV, Pitkala KH, Strandberg TE, Tilvis RS. Confusion assessment method in the diagnostics of delirium among aged hospital patients: would it serve better in screening than as a diagnostic instrument? Int. J. Geriatr. Psych. 17, 1112-1119 (2002).
50. Ely EW, Margolin R, Francis J et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit. Care Med. 29, 1370-1379 (2001).
51. Breitbart W, Rosenfeld B, Roth A, Smith MJ, Cohen K, Passik S. The memorial delirium assessment scale. J. Pain Symptom Manage. 13, 128-137 (1997).
52. Trzepacz PT, Mittal D, Torres R, Kanary K, Norton J, Jimerson N. Validation of the Delirium rating scale-revised-98: comparison with the delirium rating scale and the cognitive test for delirium. J. Neuropsych. Clin. Neurosci. 13, 229-242 (2001).
53. Gaudreau J-D, Gagnon P, Harel F, Tremblay A, Roy MA. Fast, systematic, and continuous delirium assessment in hospitalised patients: the nursing delirium scale. J. Pain Symptom Manage. 29, 368-375 (2005).
54. Folstein MF, Folstein SE, McHugh PR. Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 12, 189-198 (1975).
55. Britton A, Russell R. Multidisciplinary team intervention for delirium in patients with chronic cognitive impairment (review). In: The Cochrane Library Issue 3, Oxford, UK (2005).
56. Fick DM, Agostini JV, Inouye SK. Delirium superimposed on dementia: a systematic review. J. Am. Geriatr. Soc. 50, 1723-1732 (2002).
57. O'Keeffe ST, Mulkerrin EC, Nayeem K, Varughese M, Pillay I. Use of serial mini-mental state examinations to diagnose and monitor delirium in elderly hospital patients. J. Am. Geriatr. Soc. 53, 867-870 (2005).
58. Adamis D, Morrison C, Treloar A, Macdonald AJD, Martin FC. The performance of the clock drawing test in elderly medical inpatients: does it have utility in the identification of delirium? J. Geriatr. Psych. Neurol. 18, 129-133 (2005).
59. Bhat R, Rockwood K. Inter-rater reliability of delirium rating scales. Neuroepidemiology 25, 48-52 (2005).
60. Lovett WC, Stokes DK, Taylor LB, Young ML, Free SM, Phelan DG. Management of behavioral symptoms in disturbed elderly patients: comparison of trifluoperazine and haloperidol. J. Clin. Psych. 48, 234-236 (1987).
61. Silver PA, Simpson GM. Antipsychotic use in the medically ill. Psychother. Psychosom. 49, 120-136 (1988).
62. Adams F. Emergency intravenous sedation of the delirious, medically ill patient. J. Clin. Psych. 49(Suppl.), 22-27 (1988).
63. American Psychiatric Association. Practice guideline for the treatment of patients with delirium. Am. J. Psych. 156(5 Suppl.), 1-20 (1999).
64. Tune L. The role of antipsychotics in treating delirium. Curr. Psychiatry Rep. 4, 209-212 (2002).
65. Schwartz TL, Masand PS. The role of atypical antipsychotics in the treatment of delirium. Psychosomatics 43, 171-174 (2002).
66. Kim KY, Bader GM, Kotlyar V, Gropper D. Treatment of delirium in older adults with quetiapine. J. Geriatr. Psych. Neurol. 16, 29-31 (2003).
67. Horikawa N, Yamazaki T, Miyamoto K et al. Treatment for delirium with risperidone: results of a prospective open trial with 10 patients. Gen. Hosp. Psychiatry 25, 289-292 (2003).
68. Skrobik YK, Bergeron N, Dumont M, Gottfried SB. Olanzapine vs haloperidol treating delirium in a critical care setting. Intensive Care Med. 30, 444-440 (2004).
69. Lee KU, won WY, Lee HK et al. Amisulpride versus quetiapine for the treatment of delirium: a randomized, open prospective study. Int. Clin. Psychopharmacol. 20, 311-314 (2005).
70. Pae CU, Lee SJ, Lee C, Paik IH. A pilot trial of quetiapine for the treatment of patients with delirium. Human Psychopharmacol. 19, 125-127 (2004).
71. Han CS, Kim YK. A double-blind trial of risperidone and haloperidol for the treatment of delirium. Psychosomatics 45, 297-301 (2004).
72. Neil W, Curran S, Wattis J. Antipsychotic prescribing in older people. Age Ageing 32, 475-483 (2003).
73. Pandharipande P, Shintani A, Peterson J et al. Lorazepam is an independent risk factor for transitioning to delirium in intensive care unit patients. Anesthesiology 104, 21-26 (2006).
74. Carnes M, Howell T, Rosenberg M, Francis J, Hildebrand C, Knupped J. Physicians vary in approaches to the clinical management of delirium. J. Am. Geriatr. Soc. 51, 234-239 (2003).
75. Trzepacz PT. Is there a final common neural pathway in delirium? Focus on acetylcholine and dopamine. Semin. Clin. Neuropsych. 5, 132-148 (2000).
76. Dautzenberg PL, Mulder LJ, Olde Rikkert MG, Wouters CJ, Loonen AJ. Delirium in elderly hospitalised patients: protective effects of chronic rivastigmine usage. Int. J. Geriatr. Psychiatry 19, 641-644 (2004).
77. Moretti R, Torre P, Antonello RM, Cattaruzza T, Cazzato G. Cholinesterase inhibition as a possible therapy for delirium in vascular dementia: a controlled, open 24-month study of 246 patients. Am. J. Alzheimer's Dis. Other Demen. 19, 333-339 (2004).
78. Slatkin N, Rhiner M. Treatment of opioid-induced delirium with acetylcholinesterase inhibitors: a case report. J. Pain Symptom Manage. 27, 268-273 (2004).
79. Jackson KC, Lipman AG. Drug therapy for delirium in terminally ill patients (review). In: The Cochrane Library, issue 3, Oxford, UK (2005).
80. Tabet N, Howard R. Delirium: Treat with care (letter). Br. Med. J. 322, 1602 (2001).
81. Flaherty JH, Tariq SH, Raghavan S, Baskshi S, Moinuddin A, Morley JE. A model for managing delirious older inpatients. J. Am. Geriatr. Soc. 51, 1031-1035 (2003).
82. Milisen K, Foreman MD, Abraham IL et al. A nurse-led interdisciplinary intervention program for delirium in elderly hip-fracture patients. J. Am. Geriatr. Soc. 49, 523-532 (2001).
83. Inouye SK, Foreman MD, Mion LC, Katz KH, Cooney LM Jr. Nurses' recognition of delirium and its symptoms: comparison of nurse and researcher ratings. Arch. Intern. Med. 161, 2467-2473 (2001).
84. Baldwin R, Pratt H, Goring H, Marriott A, Roberts C. Does a nurse-led mental health liaison service for older people reduce psychiatric morbidity in acute general medical wards? A randomised controlled trial. Age Ageing 33, 472-478 (2004).
85. Lundstrom M, Edlund A, Karlsson S, Brannstrom B, Bucht G, Gustafson Y. A multifactorial intervention program reduces the duration of delirium, length of hospitalization, and mortality in delirious patients. J. Am. Geriatr. Soc. 53, 622-628 (2005).
86. Pitkala KH, Laurila JV, Strandberg TE, Tilvis RS. Multicomponent geriatric intervention for elderly inpatients with delirium: a randomized, controlled trial. J. Gerontol. A Biol. Sci. Med. Sci. 61, 176-181 (2006).
87. Inouye SK. Prevention of delirium in hospitalized older patients: risk factors and targeted intervention strategies. Ann. Med. 32, 257-263 (2000).
88. Cole MG, Primeau F, McCusker J, Bellavance F. Effectiveness of interventions to prevent delirium in hospitalized patients: a systematic review. Can. Med. Assoc. J. 155, 1263-1268 (1996).
89. Cronin-Stubbs D. Delirium intervention research in acute care settings. Annu. Rev. Nurs. Res. 14, 57-73 (1996).
90. Kalisvaart KJ, de Jonghe JF, Bogaards MJ et al. Haloperidol prophylaxis for elderly hip-surgery patients at risk for delirium: a randomized placebo-controlled study. J. Am. Geriatr. Soc. 53, 1658-1666 (2005).
91. Liptzin B, Laki A, Garb JL, Fingeroth R, Krushell R. Donepezil in the prevention and treatment of post-surgical delirium. Am. J. Geriatr. Psychiatry 13(12), 1100-1106 (2005).
92. Milisen K, Lemiengre J, Braes T, Foreman MD. Multicomponent intervention strategies for managing delirium in hospitalised older people: systematic review. J. Adv. Nurs. 52, 79-90 (2005).
93. Inouye SK, Bogardus ST, Charpenter PA et al. A multicomponent intervention to prevent delirium in hospitalized older patients. N. Engl. J. Med. 340, 669-676 (1999).
94. Marcantonio ER, Flacker JM, Wright RJ, Resnick NM. Reducing delirium after hip fracture: a randomised trial. J. Am. Geriatr. Soc. 49, 516-522 (2001).
95. Leslie DL, Zhang Y, Bogardus ST, Holford TR, Leo-Summers LS, Inouye SK. Consequences of preventing delirium in hospitalized older adults on nursing home costs. J. Am. Geriatr. Soc. 53, 405-409 (2005).
96. Tabet N, Stewart R, Hudson S et al. Male gender influences response to an educational package for delirium prevention among older people: a stratified analysis. Int. J. Geriatr. Psch. (2006) [In Press].
97. Inouye SK, Bogardus ST, Williams CS, Leo-Summers L, Agostini JV. The role of adherence on the effectiveness of nonpharmacologic interventions: evidence from the delirium prevention trial. Arch. Intern. Med. 163, 958-964 (2003).
98. Draper B, Low LF. What is the effectiveness of acute hospital treatment of older people with mental disorders? Int. Psychogeriatr. 17, 539-555 (2005).
99. Shah A, De T. The effect of an educational intervention package about aggressive behaviour directed at the nursing staff on a continuing care psychogeriatric ward. Int. J. Geriatr. Psych. 13, 35-40 (1998).
100. Brymer C, Cavanagh P, Denomy E, Wells K, Cook C. The effect of a geriatric education program on emergency nurses. J. Emerg. Nurs. 27, 27-32 (2001).