Clinicians’ delirium treatment practice, practice change, and influences: A national online survey
Background: Recent studies cast doubt on the net effect of antipsychotics for delirium. Aim: To investigate the influence of these studies and other factors on clinicians’ delirium treatment practice and practice change in palliative care and other specialties using the Theoretical Domains Framework...
Gespeichert in:
| Veröffentlicht in: | Palliative medicine 2021-09, Vol.35 (8), p.1553-1563 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1563 |
|---|---|
| container_issue | 8 |
| container_start_page | 1553 |
| container_title | Palliative medicine |
| container_volume | 35 |
| creator | Hosie, Annmarie Agar, Meera Caplan, Gideon A Draper, Brian Hedger, Stephen Rowett, Debra Tuffin, Penny Cheah, Seong Leang Phillips, Jane L Brown, Linda Sidhu, Manraaj Currow, David C |
| description | Background:
Recent studies cast doubt on the net effect of antipsychotics for delirium.
Aim:
To investigate the influence of these studies and other factors on clinicians’ delirium treatment practice and practice change in palliative care and other specialties using the Theoretical Domains Framework.
Design:
Australia-wide online survey of relevant clinicians.
Setting/participants:
Registered nurses (72%), doctors (16%), nurse practitioners (6%) and pharmacists (5%) who cared for patients with delirium in diverse settings, recruited through health professionals’ organisations.
Results:
Most of the sample (n = 475): worked in geriatrics/aged (31%) or palliative care (30%); in hospitals (64%); and saw a new patient with delirium at least weekly (61%). More (59%) reported delirium practice change since 2016, mostly by increased non-pharmacological interventions (53%). Fifty-five percent reported current antipsychotic use for delirium, primarily for patient distress (79%) and unsafe behaviour (67%). Common Theoretical Domains Framework categories of influences on respondents’ delirium practice were: emotion (54%); knowledge (53%) and physical (43%) and social (21%) opportunities. Palliative care respondents more often reported: awareness of any named key study of antipsychotics for delirium (73% vs 39%, p |
| doi_str_mv | 10.1177/02692163211022183 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2538048096</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_02692163211022183</sage_id><sourcerecordid>2572840659</sourcerecordid><originalsourceid>FETCH-LOGICAL-c388t-3504205f0d29fe38879512e56da8ea3a3dbe36e6a2dc371b77f0a04f66df7f753</originalsourceid><addsrcrecordid>eNp1kM1KxDAUhYMoOI4-gLuAGxd2vEnapHUng38w4EbBXcmkN2OGTjomrTA7X8PX80lsGVFQXN3Lud85XA4hxwwmjCl1DlwWnEnBGQPOWS52yIilSiUg4GmXjIZ7MgD75CDGJQATINMRqaa188447ePH2zutsHbBdSvaBtTtCn1L10Gb1hk8-96oedZ-0QvaV9R5W3foDcYLekm9bl3jdU0b3-cijV14xc0h2bO6jnj0Ncfk8frqYXqbzO5v7qaXs8SIPG8TkUHKIbNQ8cJiL6kiYxwzWekctdCimqOQKDWvjFBsrpQFDamVsrLKqkyMyek2dx2alw5jW65cNFjX2mPTxZJnIoc0h0L26MkvdNl0of98oBTPU5BZ0VNsS5nQxBjQluvgVjpsSgbl0Hv5p_feM9l6ol7gT-r_hk9OYIMT</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2572840659</pqid></control><display><type>article</type><title>Clinicians’ delirium treatment practice, practice change, and influences: A national online survey</title><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>SAGE Complete</source><creator>Hosie, Annmarie ; Agar, Meera ; Caplan, Gideon A ; Draper, Brian ; Hedger, Stephen ; Rowett, Debra ; Tuffin, Penny ; Cheah, Seong Leang ; Phillips, Jane L ; Brown, Linda ; Sidhu, Manraaj ; Currow, David C</creator><creatorcontrib>Hosie, Annmarie ; Agar, Meera ; Caplan, Gideon A ; Draper, Brian ; Hedger, Stephen ; Rowett, Debra ; Tuffin, Penny ; Cheah, Seong Leang ; Phillips, Jane L ; Brown, Linda ; Sidhu, Manraaj ; Currow, David C</creatorcontrib><description><![CDATA[Background:
Recent studies cast doubt on the net effect of antipsychotics for delirium.
Aim:
To investigate the influence of these studies and other factors on clinicians’ delirium treatment practice and practice change in palliative care and other specialties using the Theoretical Domains Framework.
Design:
Australia-wide online survey of relevant clinicians.
Setting/participants:
Registered nurses (72%), doctors (16%), nurse practitioners (6%) and pharmacists (5%) who cared for patients with delirium in diverse settings, recruited through health professionals’ organisations.
Results:
Most of the sample (n = 475): worked in geriatrics/aged (31%) or palliative care (30%); in hospitals (64%); and saw a new patient with delirium at least weekly (61%). More (59%) reported delirium practice change since 2016, mostly by increased non-pharmacological interventions (53%). Fifty-five percent reported current antipsychotic use for delirium, primarily for patient distress (79%) and unsafe behaviour (67%). Common Theoretical Domains Framework categories of influences on respondents’ delirium practice were: emotion (54%); knowledge (53%) and physical (43%) and social (21%) opportunities. Palliative care respondents more often reported: awareness of any named key study of antipsychotics for delirium (73% vs 39%, p < 0.001); changed delirium treatment (73% vs 53%, p = 0.017); decreased pharmacological interventions (60% vs 15%, p < 0.001); off-label medication use (86% vs 51%, p < 0.001: antipsychotics 79% vs 44%, p < 0.001; benzodiazepines 61% vs 26%, p < 0.001) and emotion as an influence (82% vs 39%, p < 0.001).
Conclusion:
Clinicians’ use of antipsychotic during delirium remains common and is primarily motivated by distress and safety concerns for the patient and others nearby. Supporting clinicians to achieve evidence-based delirium practice requires further work.]]></description><identifier>ISSN: 0269-2163</identifier><identifier>EISSN: 1477-030X</identifier><identifier>DOI: 10.1177/02692163211022183</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Antipsychotics ; Benzodiazepines ; Change agents ; Delirium ; Disease management ; Drugs ; Hospitals ; Intervention ; Medical personnel ; Nurse practitioners ; Nurses ; Off-label ; Palliative care ; Pharmacists ; Physicians ; Polls & surveys ; Psychological distress ; Psychotropic drugs ; Unsafe</subject><ispartof>Palliative medicine, 2021-09, Vol.35 (8), p.1553-1563</ispartof><rights>The Author(s) 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c388t-3504205f0d29fe38879512e56da8ea3a3dbe36e6a2dc371b77f0a04f66df7f753</citedby><cites>FETCH-LOGICAL-c388t-3504205f0d29fe38879512e56da8ea3a3dbe36e6a2dc371b77f0a04f66df7f753</cites><orcidid>0000-0003-1988-1250 ; 0000-0002-3691-8230 ; 0000-0003-1674-2124</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/02692163211022183$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/02692163211022183$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,30976,43597,43598</link.rule.ids></links><search><creatorcontrib>Hosie, Annmarie</creatorcontrib><creatorcontrib>Agar, Meera</creatorcontrib><creatorcontrib>Caplan, Gideon A</creatorcontrib><creatorcontrib>Draper, Brian</creatorcontrib><creatorcontrib>Hedger, Stephen</creatorcontrib><creatorcontrib>Rowett, Debra</creatorcontrib><creatorcontrib>Tuffin, Penny</creatorcontrib><creatorcontrib>Cheah, Seong Leang</creatorcontrib><creatorcontrib>Phillips, Jane L</creatorcontrib><creatorcontrib>Brown, Linda</creatorcontrib><creatorcontrib>Sidhu, Manraaj</creatorcontrib><creatorcontrib>Currow, David C</creatorcontrib><title>Clinicians’ delirium treatment practice, practice change, and influences: A national online survey</title><title>Palliative medicine</title><addtitle>Palliat Med</addtitle><description><![CDATA[Background:
Recent studies cast doubt on the net effect of antipsychotics for delirium.
Aim:
To investigate the influence of these studies and other factors on clinicians’ delirium treatment practice and practice change in palliative care and other specialties using the Theoretical Domains Framework.
Design:
Australia-wide online survey of relevant clinicians.
Setting/participants:
Registered nurses (72%), doctors (16%), nurse practitioners (6%) and pharmacists (5%) who cared for patients with delirium in diverse settings, recruited through health professionals’ organisations.
Results:
Most of the sample (n = 475): worked in geriatrics/aged (31%) or palliative care (30%); in hospitals (64%); and saw a new patient with delirium at least weekly (61%). More (59%) reported delirium practice change since 2016, mostly by increased non-pharmacological interventions (53%). Fifty-five percent reported current antipsychotic use for delirium, primarily for patient distress (79%) and unsafe behaviour (67%). Common Theoretical Domains Framework categories of influences on respondents’ delirium practice were: emotion (54%); knowledge (53%) and physical (43%) and social (21%) opportunities. Palliative care respondents more often reported: awareness of any named key study of antipsychotics for delirium (73% vs 39%, p < 0.001); changed delirium treatment (73% vs 53%, p = 0.017); decreased pharmacological interventions (60% vs 15%, p < 0.001); off-label medication use (86% vs 51%, p < 0.001: antipsychotics 79% vs 44%, p < 0.001; benzodiazepines 61% vs 26%, p < 0.001) and emotion as an influence (82% vs 39%, p < 0.001).
Conclusion:
Clinicians’ use of antipsychotic during delirium remains common and is primarily motivated by distress and safety concerns for the patient and others nearby. Supporting clinicians to achieve evidence-based delirium practice requires further work.]]></description><subject>Antipsychotics</subject><subject>Benzodiazepines</subject><subject>Change agents</subject><subject>Delirium</subject><subject>Disease management</subject><subject>Drugs</subject><subject>Hospitals</subject><subject>Intervention</subject><subject>Medical personnel</subject><subject>Nurse practitioners</subject><subject>Nurses</subject><subject>Off-label</subject><subject>Palliative care</subject><subject>Pharmacists</subject><subject>Physicians</subject><subject>Polls & surveys</subject><subject>Psychological distress</subject><subject>Psychotropic drugs</subject><subject>Unsafe</subject><issn>0269-2163</issn><issn>1477-030X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNp1kM1KxDAUhYMoOI4-gLuAGxd2vEnapHUng38w4EbBXcmkN2OGTjomrTA7X8PX80lsGVFQXN3Lud85XA4hxwwmjCl1DlwWnEnBGQPOWS52yIilSiUg4GmXjIZ7MgD75CDGJQATINMRqaa188447ePH2zutsHbBdSvaBtTtCn1L10Gb1hk8-96oedZ-0QvaV9R5W3foDcYLekm9bl3jdU0b3-cijV14xc0h2bO6jnj0Ncfk8frqYXqbzO5v7qaXs8SIPG8TkUHKIbNQ8cJiL6kiYxwzWekctdCimqOQKDWvjFBsrpQFDamVsrLKqkyMyek2dx2alw5jW65cNFjX2mPTxZJnIoc0h0L26MkvdNl0of98oBTPU5BZ0VNsS5nQxBjQluvgVjpsSgbl0Hv5p_feM9l6ol7gT-r_hk9OYIMT</recordid><startdate>202109</startdate><enddate>202109</enddate><creator>Hosie, Annmarie</creator><creator>Agar, Meera</creator><creator>Caplan, Gideon A</creator><creator>Draper, Brian</creator><creator>Hedger, Stephen</creator><creator>Rowett, Debra</creator><creator>Tuffin, Penny</creator><creator>Cheah, Seong Leang</creator><creator>Phillips, Jane L</creator><creator>Brown, Linda</creator><creator>Sidhu, Manraaj</creator><creator>Currow, David C</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1988-1250</orcidid><orcidid>https://orcid.org/0000-0002-3691-8230</orcidid><orcidid>https://orcid.org/0000-0003-1674-2124</orcidid></search><sort><creationdate>202109</creationdate><title>Clinicians’ delirium treatment practice, practice change, and influences: A national online survey</title><author>Hosie, Annmarie ; Agar, Meera ; Caplan, Gideon A ; Draper, Brian ; Hedger, Stephen ; Rowett, Debra ; Tuffin, Penny ; Cheah, Seong Leang ; Phillips, Jane L ; Brown, Linda ; Sidhu, Manraaj ; Currow, David C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c388t-3504205f0d29fe38879512e56da8ea3a3dbe36e6a2dc371b77f0a04f66df7f753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Antipsychotics</topic><topic>Benzodiazepines</topic><topic>Change agents</topic><topic>Delirium</topic><topic>Disease management</topic><topic>Drugs</topic><topic>Hospitals</topic><topic>Intervention</topic><topic>Medical personnel</topic><topic>Nurse practitioners</topic><topic>Nurses</topic><topic>Off-label</topic><topic>Palliative care</topic><topic>Pharmacists</topic><topic>Physicians</topic><topic>Polls & surveys</topic><topic>Psychological distress</topic><topic>Psychotropic drugs</topic><topic>Unsafe</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hosie, Annmarie</creatorcontrib><creatorcontrib>Agar, Meera</creatorcontrib><creatorcontrib>Caplan, Gideon A</creatorcontrib><creatorcontrib>Draper, Brian</creatorcontrib><creatorcontrib>Hedger, Stephen</creatorcontrib><creatorcontrib>Rowett, Debra</creatorcontrib><creatorcontrib>Tuffin, Penny</creatorcontrib><creatorcontrib>Cheah, Seong Leang</creatorcontrib><creatorcontrib>Phillips, Jane L</creatorcontrib><creatorcontrib>Brown, Linda</creatorcontrib><creatorcontrib>Sidhu, Manraaj</creatorcontrib><creatorcontrib>Currow, David C</creatorcontrib><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Palliative medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hosie, Annmarie</au><au>Agar, Meera</au><au>Caplan, Gideon A</au><au>Draper, Brian</au><au>Hedger, Stephen</au><au>Rowett, Debra</au><au>Tuffin, Penny</au><au>Cheah, Seong Leang</au><au>Phillips, Jane L</au><au>Brown, Linda</au><au>Sidhu, Manraaj</au><au>Currow, David C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinicians’ delirium treatment practice, practice change, and influences: A national online survey</atitle><jtitle>Palliative medicine</jtitle><addtitle>Palliat Med</addtitle><date>2021-09</date><risdate>2021</risdate><volume>35</volume><issue>8</issue><spage>1553</spage><epage>1563</epage><pages>1553-1563</pages><issn>0269-2163</issn><eissn>1477-030X</eissn><abstract><![CDATA[Background:
Recent studies cast doubt on the net effect of antipsychotics for delirium.
Aim:
To investigate the influence of these studies and other factors on clinicians’ delirium treatment practice and practice change in palliative care and other specialties using the Theoretical Domains Framework.
Design:
Australia-wide online survey of relevant clinicians.
Setting/participants:
Registered nurses (72%), doctors (16%), nurse practitioners (6%) and pharmacists (5%) who cared for patients with delirium in diverse settings, recruited through health professionals’ organisations.
Results:
Most of the sample (n = 475): worked in geriatrics/aged (31%) or palliative care (30%); in hospitals (64%); and saw a new patient with delirium at least weekly (61%). More (59%) reported delirium practice change since 2016, mostly by increased non-pharmacological interventions (53%). Fifty-five percent reported current antipsychotic use for delirium, primarily for patient distress (79%) and unsafe behaviour (67%). Common Theoretical Domains Framework categories of influences on respondents’ delirium practice were: emotion (54%); knowledge (53%) and physical (43%) and social (21%) opportunities. Palliative care respondents more often reported: awareness of any named key study of antipsychotics for delirium (73% vs 39%, p < 0.001); changed delirium treatment (73% vs 53%, p = 0.017); decreased pharmacological interventions (60% vs 15%, p < 0.001); off-label medication use (86% vs 51%, p < 0.001: antipsychotics 79% vs 44%, p < 0.001; benzodiazepines 61% vs 26%, p < 0.001) and emotion as an influence (82% vs 39%, p < 0.001).
Conclusion:
Clinicians’ use of antipsychotic during delirium remains common and is primarily motivated by distress and safety concerns for the patient and others nearby. Supporting clinicians to achieve evidence-based delirium practice requires further work.]]></abstract><cop>London, England</cop><pub>SAGE Publications</pub><doi>10.1177/02692163211022183</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-1988-1250</orcidid><orcidid>https://orcid.org/0000-0002-3691-8230</orcidid><orcidid>https://orcid.org/0000-0003-1674-2124</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0269-2163 |
| ispartof | Palliative medicine, 2021-09, Vol.35 (8), p.1553-1563 |
| issn | 0269-2163 1477-030X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2538048096 |
| source | Applied Social Sciences Index & Abstracts (ASSIA); SAGE Complete |
| subjects | Antipsychotics Benzodiazepines Change agents Delirium Disease management Drugs Hospitals Intervention Medical personnel Nurse practitioners Nurses Off-label Palliative care Pharmacists Physicians Polls & surveys Psychological distress Psychotropic drugs Unsafe |
| title | Clinicians’ delirium treatment practice, practice change, and influences: A national online survey |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-10T02%3A43%3A27IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Clinicians%E2%80%99%20delirium%20treatment%20practice,%20practice%20change,%20and%20influences:%20A%20national%20online%20survey&rft.jtitle=Palliative%20medicine&rft.au=Hosie,%20Annmarie&rft.date=2021-09&rft.volume=35&rft.issue=8&rft.spage=1553&rft.epage=1563&rft.pages=1553-1563&rft.issn=0269-2163&rft.eissn=1477-030X&rft_id=info:doi/10.1177/02692163211022183&rft_dat=%3Cproquest_cross%3E2572840659%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2572840659&rft_id=info:pmid/&rft_sage_id=10.1177_02692163211022183&rfr_iscdi=true |