Delirium management by palliative medicine specialists

  • Boland JW & al.
  • BMJ Support Palliat Care
  • 4 Mar 2019

  • curated by Dawn O'Shea
  • UK Medical News
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A survey of UK palliative medicine specialists has found that delirium screening at inpatient admission is suboptimal.

A 21-question online anonymous survey was emailed to Association for Palliative Medicine members in current clinical practice (n=859), asking about delirium assessment, management and research priorities.

The overall response rate was 39 per cent, with 70 per cent identifying themselves as palliative medicine consultants.

The findings revealed that almost 40 per cent of teams providing palliative care services do not use any guidelines in relation to the management of delirium, and on inpatient admission, 41 per cent never use a delirium screening tool to assess patients.

Most respondents said they would use non-pharmacological interventions to manage delirium, either alone (39%) or with an antipsychotic (58%), despite emerging evidence suggesting that antipsychotic use should be minimised in managing mild to moderate severity delirium. More than 90 per cent said they would prescribe an antipsychotic to manage distressing hallucinations unresponsive to non-pharmacological measures, while and 6 per cent would prescribe a benzodiazepine.

Responses also showed that 57 per cent of inpatient teams and 60 per cent of community teams do not provide formal support to family carers.

The research is published in the BMJ Supportive and Palliative Care.

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