To evaluate the effect of non-pharmacological interventions versus standard care on incidence and duration of delirium in critically ill patients.
We searched electronic and grey literature for randomised clinical trials up to March 2018. Two reviewers independently screened, selected and extracted data. Meta-analysis was undertaken using random effects modelling.
We identified 15 trials (2812 participants). Eleven trials reported incidence of delirium. Pooled data from four trials of bright light therapy showed no significant effect between groups (n = 829 participants, RR 0.45, 99% CI 0.10–2.13, P = 0.19, very low quality evidence). Seven trials of various individual interventions also failed to report any significant effects. A total of eight trials reported duration of delirium. Pooled data from two trials of multicomponent physical therapy showed no significant effect [n = 404 participants, MD (days) − 0.65, 99% CI − 2.73 to 1.44, P = 0.42, low quality of evidence]. Four trials of various individual interventions also reported no significant effects. A trial of family voice reorientation showed a beneficial effect [n = 30, MD (days) − 1.30, 99% CI − 2.41 to − 0.19, P = 0.003, very low quality evidence].
Current evidence does not support the use of non-pharmacological interventions in reducing incidence and duration of delirium in critically ill patients. Future research should consider well-designed and well-described multicomponent interventions and include adequately defined outcome measures.
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Methodological issues in relation to the use of surrogate and composite outcome measures in critical care trialsAuthor: Verghis, R., Jul 2022
Student thesis: Doctoral Thesis › Doctor of Philosophy
The development of a non-pharmacological intervention for delirium management in critically ill patientsAuthor: Bannon, L., Dec 2021
Student thesis: Doctoral Thesis › Doctor of PhilosophyFile