Software-guided (PREVEDEL) cognitive stimulation to prevent delirium in hospitalised older adults: study protocol
Abstract Background Delirium is a clinical condition characterised by acute and fluctuating deterioration of the cognitive state, generally secondary to an acute pathology. Delirium is associated with negative outcomes in older adults, such as longer hospitalisations, higher mortality, and short and...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-08-01
|
| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-023-04189-2 |
| _version_ | 1827633217494056960 |
|---|---|
| author | Maricel Garrido Evelyn Álvarez Felipe Salech Verónica Rojas Nicole Jara José Ignacio Farías Daniela Ponce de la Vega Eduardo Tobar |
| author_facet | Maricel Garrido Evelyn Álvarez Felipe Salech Verónica Rojas Nicole Jara José Ignacio Farías Daniela Ponce de la Vega Eduardo Tobar |
| author_sort | Maricel Garrido |
| collection | DOAJ |
| description | Abstract Background Delirium is a clinical condition characterised by acute and fluctuating deterioration of the cognitive state, generally secondary to an acute pathology. Delirium is associated with negative outcomes in older adults, such as longer hospitalisations, higher mortality, and short and medium-term institutionalisation. Randomised clinical trials have shown that delirium is preventable through non-pharmacological prevention measures, decreasing its incidence by 30–50%. These interventions include promoting physical activity, facilitating the use of glasses and hearing aids, cognitive stimulation, and providing frequent reorientation of time and space, among others. These measures are currently seldom applied in hospitals in Chile and around the world for reasons including the heavy workload of clinical staff, the lack of trained personnel, and in general the absence of a systematic implementation processes. We developed a software called PREVEDEL, which includes non-pharmacological strategies such as cognitive stimulation, early mobilisation, orientation, and pain assessment. We propose a randomised clinical trial to evaluate whether cognitive stimulation guided by PREVEDEL software prevents delirium status (full/subsyndromal delirium) in hospitalised older adults. Method A randomised controlled trial, with parallel, multicentre groups. We will recruite patients 65 years or older who have been hospitalised for less than 48 h in the general ward or the intermediate care units of four hospitals in Santiago, Chile. The participants in the intervention group will use a tablet with cognitive stimulation software for delirium prevention for five continuous days versus the control group who will use the tablet without the software. We will evaluate the incidence, duration, density of delirium, subsyndromal delirium with the Confusion Assessment Method, cognitive with the Montreal Cognitive Assessment, and functional status with the Functional Independence Measure at discharge. Moreover, we will evaluate the adherence to prevention measures, as well as demographic variables of interest. Discussion The use of cognitive PREVEDEL software could increase and improve the implementation of non-pharmacological prevention measures for delirium in hospitalised older adults, thus reducing its incidence and contributing to patients and health professionals. Trial registration NCT05108207 ClinicalTrials.gov. Registered 4 November 2021. |
| first_indexed | 2024-03-09T14:56:27Z |
| format | Article |
| id | doaj.art-b4546856d0ff4b388adb35266a0186d9 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-03-09T14:56:27Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-b4546856d0ff4b388adb35266a0186d92023-11-26T14:10:11ZengBMCBMC Geriatrics1471-23182023-08-012311710.1186/s12877-023-04189-2Software-guided (PREVEDEL) cognitive stimulation to prevent delirium in hospitalised older adults: study protocolMaricel Garrido0Evelyn Álvarez1Felipe Salech2Verónica Rojas3Nicole Jara4José Ignacio Farías5Daniela Ponce de la Vega6Eduardo Tobar7Departamento de Medicina, Servicio de Medicina Física y Rehabilitación, Hospital Clínico de La Universidad de ChileDepartamento de Terapia Ocupacional y Ciencia de La Ocupación, Facultad de Medicina, Universidad de ChileCentro de Investigación Clínica Avanzada (CICA), Hospital Clínico de La Universidad de ChileCentro de Investigación Clínica Avanzada (CICA), Hospital Clínico de La Universidad de ChileDepartamento de Medicina, Servicio de Medicina Física y Rehabilitación, Hospital Clínico de La Universidad de ChileCentro de Investigación Clínica Avanzada (CICA), Hospital Clínico de La Universidad de ChileCentro de Investigación Clínica Avanzada (CICA), Hospital Clínico de La Universidad de ChileDepartamento de Medicina, Unidad de Pacientes Críticos, Hospital Clínico de La Universidad de ChileAbstract Background Delirium is a clinical condition characterised by acute and fluctuating deterioration of the cognitive state, generally secondary to an acute pathology. Delirium is associated with negative outcomes in older adults, such as longer hospitalisations, higher mortality, and short and medium-term institutionalisation. Randomised clinical trials have shown that delirium is preventable through non-pharmacological prevention measures, decreasing its incidence by 30–50%. These interventions include promoting physical activity, facilitating the use of glasses and hearing aids, cognitive stimulation, and providing frequent reorientation of time and space, among others. These measures are currently seldom applied in hospitals in Chile and around the world for reasons including the heavy workload of clinical staff, the lack of trained personnel, and in general the absence of a systematic implementation processes. We developed a software called PREVEDEL, which includes non-pharmacological strategies such as cognitive stimulation, early mobilisation, orientation, and pain assessment. We propose a randomised clinical trial to evaluate whether cognitive stimulation guided by PREVEDEL software prevents delirium status (full/subsyndromal delirium) in hospitalised older adults. Method A randomised controlled trial, with parallel, multicentre groups. We will recruite patients 65 years or older who have been hospitalised for less than 48 h in the general ward or the intermediate care units of four hospitals in Santiago, Chile. The participants in the intervention group will use a tablet with cognitive stimulation software for delirium prevention for five continuous days versus the control group who will use the tablet without the software. We will evaluate the incidence, duration, density of delirium, subsyndromal delirium with the Confusion Assessment Method, cognitive with the Montreal Cognitive Assessment, and functional status with the Functional Independence Measure at discharge. Moreover, we will evaluate the adherence to prevention measures, as well as demographic variables of interest. Discussion The use of cognitive PREVEDEL software could increase and improve the implementation of non-pharmacological prevention measures for delirium in hospitalised older adults, thus reducing its incidence and contributing to patients and health professionals. Trial registration NCT05108207 ClinicalTrials.gov. Registered 4 November 2021.https://doi.org/10.1186/s12877-023-04189-2DeliriumNon-pharmacological preventionOlder adultsSoftwareCognitive stimulation |
| spellingShingle | Maricel Garrido Evelyn Álvarez Felipe Salech Verónica Rojas Nicole Jara José Ignacio Farías Daniela Ponce de la Vega Eduardo Tobar Software-guided (PREVEDEL) cognitive stimulation to prevent delirium in hospitalised older adults: study protocol BMC Geriatrics Delirium Non-pharmacological prevention Older adults Software Cognitive stimulation |
| title | Software-guided (PREVEDEL) cognitive stimulation to prevent delirium in hospitalised older adults: study protocol |
| title_full | Software-guided (PREVEDEL) cognitive stimulation to prevent delirium in hospitalised older adults: study protocol |
| title_fullStr | Software-guided (PREVEDEL) cognitive stimulation to prevent delirium in hospitalised older adults: study protocol |
| title_full_unstemmed | Software-guided (PREVEDEL) cognitive stimulation to prevent delirium in hospitalised older adults: study protocol |
| title_short | Software-guided (PREVEDEL) cognitive stimulation to prevent delirium in hospitalised older adults: study protocol |
| title_sort | software guided prevedel cognitive stimulation to prevent delirium in hospitalised older adults study protocol |
| topic | Delirium Non-pharmacological prevention Older adults Software Cognitive stimulation |
| url | https://doi.org/10.1186/s12877-023-04189-2 |
| work_keys_str_mv | AT maricelgarrido softwareguidedprevedelcognitivestimulationtopreventdeliriuminhospitalisedolderadultsstudyprotocol AT evelynalvarez softwareguidedprevedelcognitivestimulationtopreventdeliriuminhospitalisedolderadultsstudyprotocol AT felipesalech softwareguidedprevedelcognitivestimulationtopreventdeliriuminhospitalisedolderadultsstudyprotocol AT veronicarojas softwareguidedprevedelcognitivestimulationtopreventdeliriuminhospitalisedolderadultsstudyprotocol AT nicolejara softwareguidedprevedelcognitivestimulationtopreventdeliriuminhospitalisedolderadultsstudyprotocol AT joseignaciofarias softwareguidedprevedelcognitivestimulationtopreventdeliriuminhospitalisedolderadultsstudyprotocol AT danielaponcedelavega softwareguidedprevedelcognitivestimulationtopreventdeliriuminhospitalisedolderadultsstudyprotocol AT eduardotobar softwareguidedprevedelcognitivestimulationtopreventdeliriuminhospitalisedolderadultsstudyprotocol |