Knowledge of residents about delirium and its management in the elderly and restless patient

Delirium is frequent and serious, while it is often avoidable. Previous studies revealed a caregivers lack of knowledge about this syndrome concerning diagnosis and therapeutic management. In France, residents are often in first line to manage delirium patients. The purpose of this study is therefore to assess residents' level of knowledge about delirium and its therapeutic management in the elderly. Our study is a national survey carried out between June and December 2019 using a self-administrated survey derived from the 2009 Haute Autorité de santé (HAS) recommendations about delirium. The primary endpoint was the global score obtained by residents. The secondary endpoints were the score in different fields of competence (general knowledge, diagnostic, therapeutic) and the comparison of the resident's score according to their formation. One hundred eighty-two residents from 23 specialties and 18 different cities were represented. Residents were involved in more than 97% of the cases, while 45% of them were unaware of the HAS recommendations. Mean score to the survey was 68/100, and therapeutic management seemed the most difficult step, especially when the symptoms of delirium were severe. Our study highlights the benefit of practical training during internship to improve the level of knowledge on delirium. This study suggests the need for specific teaching on delirium. Training both theoretical and practical seems to be the most effective method. Development of a national educational program about delirium and its management could be proposed to improve residents awareness and develop their skill. Increasing the number of mobile geriatric teams and strengthen their action could also be a concrete option to improve delirium management. Finally, we could imagine the development of a pocket tool to offer a practical bedside help for clinicians. The development of such a tool would require further studies to evaluate its relevance and effectiveness.