Delirium in Hospitalized and ICU Patients: Systematic Review of Pharmacologic and Non-Pharmacologic Interventions

Delirium is a frequent and serious complication in hospitalized and critically ill patients, especially among older adults, leading to higher morbidity, mortality, and healthcare costs. This systematic review included five recent studies assessing pharmacologic and non-pharmacologic interventions for delirium prevention, monitoring, and management. Eligible studies involved adult or elderly hospitalized or intensive care unit (ICU) patients, with outcomes on delirium incidence, severity, or duration. The dynamic delirium (DyDel) program, a structured nurse- and family-led intervention, significantly reduced delirium incidence (5.6% vs 14.8%, p=0.0492) and duration. Suvorexant showed no significant overall reduction but decreased hyperactive/mixed subtypes (p=0.04). Delirium trajectory analyses revealed distinct clinical outcomes, with some patterns predicting higher mortality. Consistent pain, agitation, and delirium (PAD) monitoring improved clinical outcomes in multiple studies. Evidence supports structured monitoring, early risk identification, and multidisciplinary, patient-centered interventions as effective strategies to reduce delirium burden. Combining pharmacologic and non-pharmacologic approaches, especially through standardized monitoring and individualized care, can improve delirium outcomes in high-risk hospitalized populations.