A Multicomponent Nonpharmacological Intervention to Prevent Delirium for Hospitalized People with Advanced Cancer: A Phase II Cluster Randomized Waitlist Controlled Trial (The PRESERVE Pilot Study).

Hosie, A; Phillips, J; Lam, L; Kochovska, S; Noble, B; Brassil, M; Kurrle, S; Cumming, A; Caplan, GA; Chye, R; Ely, EW; Lawlor, PG; Bush, SH; Davis, JM; Lovell, M; Parr, C; Williams, S; Hauser, K; McArdle, S; Jacquier, K; Phillipson, C; Kuwahata, L; Kerfoot, J; Brown, L; Fazekas, B; Cheah, SL; Edwards, L; Green, A; Hunt, J; Attwood, R; Assen, T; Garcia, M; Wilcock, J; Agar, M

A Multicomponent Nonpharmacological Intervention to Prevent Delirium for Hospitalized People with Advanced Cancer: A Phase II Cluster Randomized Waitlist Controlled Trial (The PRESERVE Pilot Study).

Hosie, A Phillips, J

Lam, L

Kochovska, S

Noble, B Brassil, M Kurrle, S Cumming, A Caplan, GA Chye, R Ely, EW Lawlor, PG Bush, SH Davis, JM Lovell, M

Parr, C Williams, S Hauser, K McArdle, S Jacquier, K Phillipson, C Kuwahata, L Kerfoot, J Brown, L

Fazekas, B Cheah, SL Edwards, L Green, A

Hunt, J Attwood, R Assen, T Garcia, M

Wilcock, J Agar, M

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Publisher:: Mary Ann Liebert
Publication Type:: Journal Article
Citation:: Journal of Palliative Medicine, 2020, 23, (10), pp. 1314-1322
Issue Date:: 2020-10

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Field	Value	Language
dc.contributor.author	Hosie, A
dc.contributor.author	Phillips, J https://orcid.org/0000-0002-3691-8230
dc.contributor.author	Lam, L https://orcid.org/0000-0001-6183-6854
dc.contributor.author	Kochovska, S https://orcid.org/0000-0002-3531-0389
dc.contributor.author	Noble, B
dc.contributor.author	Brassil, M
dc.contributor.author	Kurrle, S
dc.contributor.author	Cumming, A
dc.contributor.author	Caplan, GA
dc.contributor.author	Chye, R
dc.contributor.author	Ely, EW
dc.contributor.author	Lawlor, PG
dc.contributor.author	Bush, SH
dc.contributor.author	Davis, JM
dc.contributor.author	Lovell, M https://orcid.org/0000-0002-1407-2748
dc.contributor.author	Parr, C
dc.contributor.author	Williams, S
dc.contributor.author	Hauser, K
dc.contributor.author	McArdle, S
dc.contributor.author	Jacquier, K
dc.contributor.author	Phillipson, C
dc.contributor.author	Kuwahata, L
dc.contributor.author	Kerfoot, J
dc.contributor.author	Brown, L https://orcid.org/0000-0003-4892-5822
dc.contributor.author	Fazekas, B
dc.contributor.author	Cheah, SL
dc.contributor.author	Edwards, L
dc.contributor.author	Green, A https://orcid.org/0000-0002-7541-3665
dc.contributor.author	Hunt, J
dc.contributor.author	Attwood, R
dc.contributor.author	Assen, T
dc.contributor.author	Garcia, M https://orcid.org/0000-0002-9496-9546
dc.contributor.author	Wilcock, J
dc.contributor.author	Agar, M https://orcid.org/0000-0002-6756-6119
dc.date.accessioned	2021-03-02T04:55:05Z
dc.date.available	2021-03-02T04:55:05Z
dc.date.issued	2020-10
dc.identifier.citation	Journal of Palliative Medicine, 2020, 23, (10), pp. 1314-1322
dc.identifier.issn	1096-6218
dc.identifier.issn	1557-7740
dc.identifier.uri	http://hdl.handle.net/10453/146625
dc.description.abstract	Background: Delirium is a common debilitating complication of advanced cancer. Objective: To determine if a multicomponent nonpharmacological delirium prevention intervention was feasible for adult patients with advanced cancer, before a phase III (efficacy) trial. Design: Phase II (feasibility) cluster randomized controlled trial. All sites implemented delirium screening and diagnostic assessment. Strategies within sleep, vision and hearing, hydration, orientation, mobility, and family domains were delivered to enrolled patients at intervention site admission days 1-7. Control sites then implemented the intervention ("waitlist sites"). Setting: Four Australian palliative care units. Measurements: The primary outcome was adherence, with an a priori endpoint of at least 60% patients achieving full adherence. Secondary outcomes were interdisciplinary care delivery, delirium measures, and adverse events, analyzed descriptively and inferentially. Results: Sixty-five enrolled patients (25 control, 20 intervention, and 20 waitlist) had 98% delirium screens and 75% diagnostic assessments completed. Nurses (67%), physicians (16%), allied health (8.4%), family (7%), patients (1%), and volunteers (0.5%) delivered the intervention. There was full adherence for 5% patients at intervention sites, partial for 25%. Both full and partial adherence were higher at waitlist sites: 25% and 45%, respectively. One-third of control site patients (32%) became delirious within seven days of admission compared to one-fifth (20%) at both intervention and waitlist sites (p = 0.5). Mean (standard deviation) Delirium Rating Scale-Revised-1998 scores were 16.8 + 12.0 control sites versus 18.4 + 8.2 (p = 0.6) intervention and 18.7 + 7.8 (p = 0.5) waitlist sites. The intervention caused no adverse events. Conclusion: The intervention requires modification for optimal adherence in a phase III trial.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Mary Ann Liebert
dc.relation.ispartof	Journal of Palliative Medicine
dc.relation.isbasedon	10.1089/jpm.2019.0632
dc.rights	info:eu-repo/semantics/embargoedAccess
dc.subject	1103 Clinical Sciences, 1110 Nursing, 1117 Public Health and Health Services
dc.subject.classification	Gerontology
dc.title	A Multicomponent Nonpharmacological Intervention to Prevent Delirium for Hospitalized People with Advanced Cancer: A Phase II Cluster Randomized Waitlist Controlled Trial (The PRESERVE Pilot Study).
dc.type	Journal Article
utslib.citation.volume	23
utslib.location.activity	United States
utslib.for	1103 Clinical Sciences
utslib.for	1110 Nursing
utslib.for	1117 Public Health and Health Services
utslib.for	1103 Clinical Sciences
utslib.for	1110 Nursing
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Research Centres
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
utslib.copyright.status	open_access	*
pubs.consider-herdc	true
utslib.copyright.embargo	2021-10-01T00:00:00+1000Z
dc.date.updated	2021-03-02T04:55:04Z
pubs.issue	10
pubs.publication-status	Published
pubs.volume	23
utslib.citation.issue	10

Abstract:

Background: Delirium is a common debilitating complication of advanced cancer. Objective: To determine if a multicomponent nonpharmacological delirium prevention intervention was feasible for adult patients with advanced cancer, before a phase III (efficacy) trial. Design: Phase II (feasibility) cluster randomized controlled trial. All sites implemented delirium screening and diagnostic assessment. Strategies within sleep, vision and hearing, hydration, orientation, mobility, and family domains were delivered to enrolled patients at intervention site admission days 1-7. Control sites then implemented the intervention ("waitlist sites"). Setting: Four Australian palliative care units. Measurements: The primary outcome was adherence, with an a priori endpoint of at least 60% patients achieving full adherence. Secondary outcomes were interdisciplinary care delivery, delirium measures, and adverse events, analyzed descriptively and inferentially. Results: Sixty-five enrolled patients (25 control, 20 intervention, and 20 waitlist) had 98% delirium screens and 75% diagnostic assessments completed. Nurses (67%), physicians (16%), allied health (8.4%), family (7%), patients (1%), and volunteers (0.5%) delivered the intervention. There was full adherence for 5% patients at intervention sites, partial for 25%. Both full and partial adherence were higher at waitlist sites: 25% and 45%, respectively. One-third of control site patients (32%) became delirious within seven days of admission compared to one-fifth (20%) at both intervention and waitlist sites (p = 0.5). Mean (standard deviation) Delirium Rating Scale-Revised-1998 scores were 16.8 + 12.0 control sites versus 18.4 + 8.2 (p = 0.6) intervention and 18.7 + 7.8 (p = 0.5) waitlist sites. The intervention caused no adverse events. Conclusion: The intervention requires modification for optimal adherence in a phase III trial.

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http://hdl.handle.net/10453/146625