Prevalence, Detection and Treatment of Delirium in Terminal Cancer Inpatients: A Prospective Survey

Fang, Chun-Kai; Chen, Hongwen; Liu, Shen‐Ing; Lin, Chen‐Ju; Tsai, Li‐Yun; Lai, Yuen-Liang

doi:10.1093/jjco/hym155

Cited by 120 publications

(118 citation statements)

References 46 publications

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“…1,3 At the end of the search, eight studies that prospectively measured the prevalence or incidence of delirium in specialist palliative care adult inpatient settings remained (Table 1). 4,5,[35][36][37][39][40][41] These included studies which were conducted in the northern hemisphere over a 12-year period (1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008).…”

Section: Resultsmentioning

confidence: 99%

“…5 Where described, the purpose of the settings included symptom control, respite, rehabilitation, and/or terminal care for palliative care patients. The majority (98.9%) of all participants (n = 1079) across these studies had advanced cancer, with some diagnoses not specified in one study.…”

Section: Setting Diagnosis and Demographicsmentioning

confidence: 99%

“…There was variability in study characteristics, design, quality, and foci, as well as participant numbers (X 120, range 41 40 -228 people 5 ). No studies reported statistical explanations for determination of sample size, with this appearing to be largely determined by number of patient admissions within study periods.…”

Section: Study Characteristics Design Quality and Focusmentioning

confidence: 99%

“…4,5 Delirium impacts upon the patient's ability to communicate, their decision-making capacity, functional ability, and quality of life. 1 Patients who recover from an episode of delirium usually recall the experience 6,7 and report feeling frightened and humiliated.…”

Section: Introductionmentioning

confidence: 99%

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Delirium prevalence, incidence, and implications for screening in specialist palliative care inpatient settings: A systematic review

et al. 2012

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Background: Delirium is a serious neuropsychiatric syndrome frequently experienced by palliative care inpatients. This syndrome is under-recognized by clinicians. While screening increases recognition, it is not a routine practice. Aim and design: This systematic review aims to examine methods, quality, and results of delirium prevalence and incidence studies in palliative care inpatient populations and discuss implications for delirium screening. Data sources: A systematic search of the literature identified prospective studies reporting on delirium prevalence and/or incidence in inpatient palliative care adult populations from 1980 to 2012. Papers not in English or those reporting the occurrence of symptoms not specifically identified as delirium were excluded. Results: Of the eight included studies, the majority (98.9%) involved participants (1079) with advanced cancer. Eight different screening and assessment tools were used. Delirium incidence ranged from 3% to 45%, while delirium prevalence varied, with a range of: 13.3%-42.3% at admission, 26%-62% during admission, and increasing to 58.8%-88% in the weeks or hours preceding death. Studies that used the Diagnostic and Statistical Manual-Fourth Edition reported higher prevalence (42%-88%) and incidence (40.2%-45%), while incidence rates were higher in studies that screened participants at least daily (32.8%-45%). Hypoactive delirium was the most prevalent delirium subtype (68%-86% of cases). Conclusion: The prevalence and incidence of delirium in palliative care inpatient settings supports the need for screening. However, there is limited consensus on assessment measures or knowledge of implications of delirium screening for inpatients and families. Further research is required to develop standardized methods of delirium screening, assessment, and management that are acceptable to inpatients and families.Palliative Medicine 27(6) 486 -498

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Section: Resultsmentioning

confidence: 99%

Section: Setting Diagnosis and Demographicsmentioning

confidence: 99%

Section: Study Characteristics Design Quality and Focusmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Delirium prevalence, incidence, and implications for screening in specialist palliative care inpatient settings: A systematic review

et al. 2012

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“…32 Delirium, depression, and anxiety are among the most common psychiatric problems that afict cancer patients and are interconnected with pain management. 33,34 Te Confusion Assessment Method is a brief screening tool for delirium that has been validated in many patient populations, including patients with advanced illnesses. 35 More detailed diagnostic tools, such as the Delirium Rating Scale Revised-98 and the Memorial Delirium Assessment Scale, can be used to confrm the diagnosis of delirium and monitor changes over time.…”

Section: Assessmentmentioning

confidence: 99%

Cancer-related pain management in clinical oncology

Cipta¹,

Pietras²,

Weiss³

et al. 2015

J Community Support Oncol

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Uncontrolled pain is one of the most feared and debilitating symptoms among cancer patients, and many suffer unnecessarily from suboptimal pain control. Cancer-related pain is often multidimensional and can affect all aspects of a patient's life. Hence, achieving adequate pain relief among cancer patients involves a proper assessment of psychosocial, spiritual, and physical pain issues, matched with an individualized treatment plan involving pharmacologic, nonpharmacologic, and procedural therapies when appropriate. Providing effective pain relief can help ease the overall burden of disease among oncology patients while helping them tolerate cancer-directed therapies and achieve the most optimal quality of life throughout all phases of the disease continuum. In this review, the authors will discuss the syndromes, assessment of, and treatment for cancer-related pain in the outpatient setting.

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Psychosocial Oncology

Nezu

Felgoise

et al. 2012

Handbook of Psychology, Second Edition

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Prevalence, Detection and Treatment of Delirium in Terminal Cancer Inpatients: A Prospective Survey

Abstract: The prevalence of delirium was high, but the rates of detection and treatment were low. Interventions are recommended to improve the diagnosis and treatment of delirium in palliative care units.

Cited by 120 publications

References 46 publications

Delirium prevalence, incidence, and implications for screening in specialist palliative care inpatient settings: A systematic review

Delirium prevalence, incidence, and implications for screening in specialist palliative care inpatient settings: A systematic review

Cancer-related pain management in clinical oncology

Psychosocial Oncology

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