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Trial registered on ANZCTR
Registration number
ACTRN12608000204347
Ethics application status
Approved
Date submitted
7/03/2008
Date registered
16/04/2008
Date last updated
16/04/2008
Type of registration
Retrospectively registered
Titles & IDs
Public title
Prevention and Management of Delirium in Older General Medical Patients
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Scientific title
A Multidisciplinary Intervention Implementing Clinical Practice Guidelines for the Prevention and Management of Delirium in Older Acute General Medical Patients
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Delirium
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Condition category
Condition code
Neurological
3047
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients with established delirium or an intermediate-high risk assessment will be identified through early screening and fast tracked from the Emergency Department to the intervention ward. The intervention ward will be modified to provide an appropriate sensory environment. The intervention will be administered by the existing multidisciplinary team and will be in line with Clinical Practice Guidelines for the prevention and treatment of delirium. Patients will undergo comprehensive medical, nursing and allied health assessment with regard to modifiable risk factors. Nursing assistants, volunteers and carers will assist in re-orientation and distraction therapy. The intervention will continue for the duration of the patient's admission.
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Intervention code [1]
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Early detection / Screening
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Intervention code [2]
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Prevention
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Intervention code [3]
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Treatment: Other
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Comparator / control treatment
Standard treatment involves medical care plus early allied health referral and assessment of risks pertaining to discharge planning.
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Control group
Active
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Outcomes
Primary outcome [1]
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Overall incidence delirium will be measured by applying the Confusion Assessment Method (CAM)
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Assessment method [1]
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Timepoint [1]
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At 48 hours, prior to discharge
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Secondary outcome [1]
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Time to resolution of delirium will be measured by applying the Confusion Assessment Method (CAM) at intervals and documenting days to resolution of delirium
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Assessment method [1]
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Timepoint [1]
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Day 4,7; weekly until patient discharge
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Secondary outcome [2]
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Length of stay
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Assessment method [2]
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Timepoint [2]
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Discharge
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Secondary outcome [3]
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Documented falls
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Assessment method [3]
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Timepoint [3]
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Discharge
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Secondary outcome [4]
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Cognitive decline will be measured by applying either Abbreviated Mental Test (AMT) or Mini-Mental State Examination (MMSE) and functional decline through application of a modified Katz Activities of Daily Living (ADL) assessment
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Assessment method [4]
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Timepoint [4]
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Admission, discharge
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Eligibility
Key inclusion criteria
Patients are eligible for study if admitted to participating medical units; aged 65 years or greater; and at intermediate-high risk of delirium following application of screening tool.
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Minimum age
65
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Palliative patients; combative/dangerous behaviour; hyperactive delirium requiring AIN special >4 hours daily; non invasive ventilation/tracheostomy; post ICU; severe psychiatric disorder preventing participation in interventions; severe dementia; discharge anticipated within 72 hours admission; aphasia; any condition not listed above that prevents participation in intervention ward programme
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
4/02/2008
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
406
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
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4029
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Strengthening Aged Care
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Address [1]
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Central Area Health Service
Queensland Health
CitiLink Business Centre
153 Campbell St Herston QLD 4006
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Dr Catherine Maussen
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Address
Staff Specialist Internal Medicine
Level 3
James Mayne Building
Royal Brisbane and Women's Hospital
Butterfield St
Herston QLD 4029
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Dr Charles Denaro
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Address [1]
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Director Internal Medicine
Level 3
James Mayne Building
Royal Brisbane and Women's Hospital
Butterfield St
Herston QLD 4029
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Country [1]
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Australia
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Secondary sponsor category [2]
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Individual
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Name [2]
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Dr Alison Mudge
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Address [2]
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Staff Specialist Internal Medicine
Level 3
James Mayne Building
Royal Brisbane and Women's Hospital
Butterfield St
Herston QLD 4029
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Country [2]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Human Research Ethics Committee
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Ethics committee address [1]
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Royal Brisbane and Women's Hospital
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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09/01/2008
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Ethics approval number [1]
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EC001720
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Summary
Brief summary
Delirium is a common medical problem characterized by changes in medical function. It occurs in older patients with severe illness. Studies suggest that hospital staff do not always identify that a patients has delirium and so identification and treatment of causes as well as appropriate nursing management may be delayed. This project has been funded by Queensland Health. In this project, all patients aged over 65 years will be assessed for the presence of delirium and their risk of developing delirium. Patients wiith established delirium or an intermediate -high risk assessment will be admitted directly from the Emergency Department to the intervention ward. The intervention ward will be modified to provide an appropriate sensory environment. Patients will then undergo comprehensive medical, nursing and allied health assessment with regard to modifiable risk factors. Treatment will be conducted according to Clinical Practice Guidelines for the Management of Delirium in Older People. Nursing assistants, volunteers and carers will form a valuable part of the intervention. Outcomes of care with this method will be compared to the usual medical, nursing and multidisciplinary care currently provided on the other medical wards.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Ms Karen-Lee Steere Project Manager
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Address
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Royal Brisbane and Women's Hospital
Butterfield St
Herston QLD 4029
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Country
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Australia
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Phone
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+61 7 36365789
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Catherine Maussen
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Address
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Staff Specialist Internal Medicine
Level 3
James Mayne Building
Royal Brisbane and Women's Hospital
Butterfield St
Herston QLD 4029
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Country
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Australia
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Phone
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+61 7 36367678
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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