The effectiveness of non‑pharmacological interventions in reducing the incidence and duration of delirium in critically ill patients: a systematic review and meta‑analysis

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    Purpose
    To evaluate the effect of non-pharmacological interventions versus standard care on incidence and duration of delirium in critically ill patients.

    Methods
    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.

    Results
    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].

    Conclusions
    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.

    Documents

    • The effectiveness of non-pharmacological interventions in reducing the incidence and duration of delirium in critically ill patients: a systematic review and meta-analysis

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      Accepted author manuscript, 229 KB, PDF-document

      Embargo ends: 30/11/2019

    DOI

    Original languageEnglish
    JournalIntensive Care Medicine
    Journal publication date30 Nov 2018
    Early online date30 Nov 2018
    DOIs
    Publication statusEarly online date - 30 Nov 2018

    ID: 161786511