Non-pharmacological interventions to tackle delirium in elderly hospitalised patients? A scoping review.

Background: Delirium is an acute neuropsychiatric syndrome that is characterised by fluctuations in attention, awareness and cognition. Delirium has a high prevalence within hospitals and is associated with increased morbidity and mortality. This incurs substantial healthcare associated costs and often prolongs the duration of hospital admissions, placing strain on the patient and their family and impacting upon the availability of hospital resources, a widespread issue across numerous hospital trusts. Methods: A scoping review was conducted of literature exploring the current knowledge base of non- pharmacological interventions for the prevention of delirium and their efficacy using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Sources were subject to thematic analysis. Results: Four hundred and thirty-nine articles were identified through a database search on APA PsycINFO, Embase, Medline and PubMed. A total of fifteen papers were included in the final synthesis. Thematic analysis identified five major themes, including intervention type, efficacy, staff adherence and education, cost efficacy and requirements for prospective research. Conclusions: Overall, multicomponent interventions were evidenced to be effective at preventing delirium. Adherence across protocols was good and staff education was prioritised. While the field of delirium prevention lacks an abundance of high-quality experimental evidence, recent literature has begun to address the gaps in knowledge. However, further research is vital to comprehensively assess the efficacy of these interventions and expand the knowledge base of delirium prevention. Promisingly, the rising number of prospective clinical trials suggests great potential for future research in the field.