Effectiveness of the In-Hospital Information Technology System-Based Delirium Management Intervention Program in Medically Hospitalized Patients with Dementia: A Retrospective Case–Control Study

Sin-Chen Wang,1,* Wen-Fu Wang,2,* Ming-Che Chang,3,* Yu-Chun Tung,4,* Kai-Ming Jhang2 1College of Medicine, Taipei Medical University, Changhua, Taiwan; 2Neurological Institute, Changhua Christian Hospital, Changhua, Taiwan; 3Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan; 4Department of Pharmacy, Taichung Veterans General Hospital, Taichung, Taiwan*These authors contributed equally to this workCorrespondence: Kai-Ming Jhang, Neurological Institute, Changhua Christian Hospital, No. 135 Nanxiao St., Changhua City 500, Changhua, Taiwan, Tel +886 4 7238595 ext. 3521, Email [email protected]: This study aimed to study the effectiveness of an information technology (IT) system-based delirium management intervention program for prevention and earlier detection of delirium in medically hospitalized patients with dementia.Patients and Methods: This was a retrospective case–control study. The study population consisted of patients aged 50– 100 years who were diagnosed with dementia and hospitalized in the general wards of neurology, psychiatry, or geriatrics. The intervention group included 101 patients receiving a delirium management protocol comprising IT-supported delirium detection, multicomponent prevention, and treatment protocols. A total of 101 controls matched for age, gender, and severity of dementia in the intervention group were selected.Results: The intervention group showed a significantly lower delirium incidence (34% versus 18%, p=0.010) and earlier detection of delirium after hospitalization (3.2 versus 2.2 days, p=0.035). Factors associated with the presence of delirium in hospitalized patients with dementia were receiving delirium management protocol (OR=0.37, 95% CI=0.16– 0.83, p=0.019) and restraints during hospitalization (OR=14.4, 95% CI=5.81– 39.1, p< 0.001).Conclusion: The in-hospital IT system-based delirium management intervention program is associated with reduced delirium incidence and earlier delirium detection after hospitalization. Appropriate delirium management and avoiding unnecessary restraints are important for hospitalized patients with dementia.Plain Language Summary: This study demonstrated the effectiveness of an information technology (IT) system-based delirium management intervention program to prevent delirium in medically hospitalized patients with dementia. The in-hospital IT system-based delirium management intervention program significantly reduces delirium incidence and can detect delirium significantly earlier after hospitalization. Appropriate delirium management and avoiding unnecessary restraints are important for hospitalized patients with dementia.Keywords: delirium prevention and management, information technology, dementia, case management, hospitalization