Quality of care in hospitalized cancer patients before and after implementation of a systematic prevention program for delirium: the DELTA exploratory trial

Asao Ogawa, Yasuyuki Okumura, Daisuke Fujisawa, Hiroyuki Takei, Chiyuki Sasaki, Kei Hirai, Yusuke Kanno, Kensuke Higa, Yasuhiko Ichida, Asuko Sekimoto, Chie Asanuma

Research output: Contribution to journalArticle

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Abstract

Background: We evaluated whether the DELirium Team Approach (DELTA) program—a systematic management program aimed at screening high-risk groups and preventing delirium—would improve quality of care in patients hospitalized with cancer. Methods: A retrospective before–after study was conducted during a pre-intervention period (between October 2012 and March 2013) and a post-intervention period (between October 2013 and March 2014) at a Japanese hospital providing specialized treatments for cancer. A total of 4180 inpatients were evaluated before the implementation of the DELTA program and 3797 inpatients were evaluated after implementation. Results: After program implementation, the incidence of delirium decreased from 7.1 to 4.3% (odds ratio [OR], 0.52; 95% CI, 0.42–0.64). The incidence of adverse events, including falls or self-extubation, also decreased, from 3.5 to 2.6% (OR, 0.71; 95% CI, 0.54–0.92). There was a significant decrease in the prescription of benzodiazepines (OR, 0.79; 95% CI, 0.71–0.87), increase in the level of independence in activities of daily living at discharge (OR, 1.94; 95% CI, 1.11–3.38), and decrease in the length of stay (risk ratio 0.90; 95% CI, 0.90–0.90). Conclusions: The systematic management program for delirium decreased the incidence of delirium and improved several clinical outcomes. These data suggest that this simple cost-effective program is feasible and implementable as routine care in busy wards.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalSupportive Care in Cancer
DOIs
Publication statusAccepted/In press - 2018 Jul 17

Fingerprint

Delirium
Quality of Health Care
Odds Ratio
Neoplasms
Inpatients
Incidence
Activities of Daily Living
Benzodiazepines
Prescriptions
Length of Stay
Retrospective Studies
Costs and Cost Analysis

Keywords

  • Cancer
  • Cognitive impairment
  • Delirium
  • Education program
  • Prevention

ASJC Scopus subject areas

  • Oncology

Cite this

Quality of care in hospitalized cancer patients before and after implementation of a systematic prevention program for delirium : the DELTA exploratory trial. / Ogawa, Asao; Okumura, Yasuyuki; Fujisawa, Daisuke; Takei, Hiroyuki; Sasaki, Chiyuki; Hirai, Kei; Kanno, Yusuke; Higa, Kensuke; Ichida, Yasuhiko; Sekimoto, Asuko; Asanuma, Chie.

In: Supportive Care in Cancer, 17.07.2018, p. 1-9.

Research output: Contribution to journalArticle

Ogawa, Asao ; Okumura, Yasuyuki ; Fujisawa, Daisuke ; Takei, Hiroyuki ; Sasaki, Chiyuki ; Hirai, Kei ; Kanno, Yusuke ; Higa, Kensuke ; Ichida, Yasuhiko ; Sekimoto, Asuko ; Asanuma, Chie. / Quality of care in hospitalized cancer patients before and after implementation of a systematic prevention program for delirium : the DELTA exploratory trial. In: Supportive Care in Cancer. 2018 ; pp. 1-9.
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AU - Ogawa, Asao

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AU - Fujisawa, Daisuke

AU - Takei, Hiroyuki

AU - Sasaki, Chiyuki

AU - Hirai, Kei

AU - Kanno, Yusuke

AU - Higa, Kensuke

AU - Ichida, Yasuhiko

AU - Sekimoto, Asuko

AU - Asanuma, Chie

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AB - Background: We evaluated whether the DELirium Team Approach (DELTA) program—a systematic management program aimed at screening high-risk groups and preventing delirium—would improve quality of care in patients hospitalized with cancer. Methods: A retrospective before–after study was conducted during a pre-intervention period (between October 2012 and March 2013) and a post-intervention period (between October 2013 and March 2014) at a Japanese hospital providing specialized treatments for cancer. A total of 4180 inpatients were evaluated before the implementation of the DELTA program and 3797 inpatients were evaluated after implementation. Results: After program implementation, the incidence of delirium decreased from 7.1 to 4.3% (odds ratio [OR], 0.52; 95% CI, 0.42–0.64). The incidence of adverse events, including falls or self-extubation, also decreased, from 3.5 to 2.6% (OR, 0.71; 95% CI, 0.54–0.92). There was a significant decrease in the prescription of benzodiazepines (OR, 0.79; 95% CI, 0.71–0.87), increase in the level of independence in activities of daily living at discharge (OR, 1.94; 95% CI, 1.11–3.38), and decrease in the length of stay (risk ratio 0.90; 95% CI, 0.90–0.90). Conclusions: The systematic management program for delirium decreased the incidence of delirium and improved several clinical outcomes. These data suggest that this simple cost-effective program is feasible and implementable as routine care in busy wards.

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