Background A crucial part of delirium care is determining if the delirium episode has resolved. Yet, there is no clear evidence or consensus on which assessments clinicians should use to assess for delirium recovery. Objective To evaluate current opinions from delirium specialists on assessment of delirium recovery. Design Online questionnaire-based survey distributed internationally to healthcare professionals involved in delirium care. Methods The survey covered methods for assessing recovery, the importance of different symptom domains for capturing recovery, and local guidance or pathways that recommend monitoring for delirium recovery. Results Responses from 199 clinicians were collected. Respondents were from the UK (51%), US (13%), Australia (9%), Canada (7%), Ireland (7%) and 16 other countries. Most respondents were doctors (52%) and nurses (27%). Clinicians worked mostly in geriatrics (52%), ICUs (21%) and acute assessment units (17%). Ninety-four percent of respondents indicated that they conduct repeat delirium assessments (i.e., on ≥2 occasions) to monitor delirium recovery. The symptom domains considered most important for capturing recovery were: arousal (92%), inattention (84%), motor disturbance (84%), and hallucinations and delusions (83%). The most used tool for assessing recovery was the 4 ’A’s Test (4AT, 51%), followed by the Confusion Assessment Method (CAM, 26%), the CAM for the ICU (CAM-ICU, 17%) and the Single Question in Delirium (SQiD, 11%). Twenty-eight percent used clinical features only. Less than half (45%) of clinicians reported having local guidance that recommends monitoring for delirium recovery. Conclusions The survey results suggest a lack of standardisation regarding tools and methods used for repeat delirium assessment, despite consensus surrounding the key domains for capturing delirium recovery. These findings emphasise the need for further research to establish best practice for assessing delirium recovery.

BACKGROUND Chronic pain is a highly prevalent condition and one of the most common reasons why people seek healthcare. As a result, chronic pain has a significant personal and economic burden. The COVID-19 pandemic has aggravated the situation for chronic pain patients, through increased risk factors (e.g., anxiety/depression) as well as decreased access to healthcare. Digital health solutions to support people with chronic pain are becoming increasingly popular. Most of the research has focused on patient-facing digital health solutions, although it is clear that involvement of health and care professionals is crucial in chronic pain care. Certainly, digital health solutions intended for the use of health and care professionals in the care of chronic pain patients (i.e., professional-facing) exist, e.g., for clinical decision support, however no review has investigated the studies reporting these interventions. OBJECTIVE The overall aim of this scoping review is to identify the available professional-facing digital health solutions for the purpose of chronic pain management. The objectives of this review are to investigate the components, target populations and user settings of the available professional-facing digital solutions, health and care professionals’ perspectives of using digital health solutions (if reported), the methods in which the digital health solutions are developed and outcomes of using professional-facing digital health solutions. METHODS Databases including MEDLINE, EMBASE, CINAHL, PsycInfo and Inspec will be searched for studies reporting professional-facing digital health solutions for chronic pain care, using a comprehensive search strategy developed for each of the specific databases. Two independent reviewers will screen the titles and abstracts for review inclusion, then conduct full-text screening. Any conflicts in study inclusion will be resolved by a third reviewer at each stage of the screening process. Following data extraction and quality assessment, a qualitative content analysis of the results will be conducted. RESULTS This review will identify the available professional-facing digital health solutions for chronic pain management. The results of this review are likely to be heterogeneous, in terms of content (i.e., the digital solutions will serve a variety of purposes, settings, target populations etc.) and methods (i.e., experimental and non-experimental designs). CONCLUSIONS This review will contribute to the growing field of research into the utility of digital health for chronic pain management. Findings from this review will help provide further information on how digital health can be used to care for chronic pain patients in a post-pandemic, digital age.

Objectives Assessing for recovery in delirium is essential in guiding ongoing investigation and treatment. Yet, there is little scrutiny and no research or clinical consensus on how recovery should be measured. We reviewed studies which used tests of neuropsychological domains and functional ability to track recovery of delirium longitudinally in acute hospital settings. Methods/Design We systematically searched databases (MEDLINE, PsycInfo, CINAHL, Embase, http://ClinicalTrials.gov, Cochrane Central Register of Controlled Trials), from inception to October 14th, 2022. Inclusion criteria were: adult acute hospital patients (≥18 years) diagnosed with delirium by a validated tool; 1+ repeat assessment using an assessment tool measuring domains of delirium/functional recovery ≤7 days from baseline. Two reviewers independently screened articles, performed data extraction, and assessed risk of bias. A narrative data synthesis was completed. Results From 6533 screened citations, we included 39 papers (reporting 32 studies), with 2370 participants with delirium. Studies reported 21 tools with an average of four repeat assessments including baseline (range 2–10 assessments within ≤7 days), measuring 15 specific domains. General cognition, functional ability, arousal, attention and psychotic features were most commonly assessed for longitudinal change. Risk of bias was moderate to high for most studies. Conclusions There was no standard approach for tracking change in specific domains of delirium. The methodological heterogeneity of studies was too high to draw firm conclusions on the effectiveness of assessment tools to measure delirium recovery. This highlights the need for standardised methods for assessing recovery from delirium.