DAMPen-D ll

Study Design: Cluster Randomised control with Economic analysis and Process Evaluation
Disease Area: Delirium
Funder: NIHR HSDR
Sponsor: University of Hull
Chief Investigator: Prof Mark Pearson and Prof Fliss Murtugh
Trial registration: ISRCTN23678136

Improving the Detection, Assessment, 
Management, and ​Prevention of
 Delirium in Palliative Care Units
(DAMPen-Delirium ll)

IN SET UP

Summary

What is the issue?

It is common for people to suffer from acute confusion (delirium) towards the end of their life. One-third of people have delirium when they are admitted to a palliative care unit or hospice and a further one-third develop delirium during their stay. People with delirium may see or hear things that aren’t there, say or do things that are out of character, and can’t ‘think straight’. This is distressing for the person, their family, and staff. Delirium also causes unnecessary ‘downward spirals’ in a person’s day-to-day abilities. This results in them having increased care needs in the community and unplanned and expensive hospital admissions. There is clear national guidance on the actions needed to prevent, detect, assess, and manage delirium. However, it is difficult for hospices to put this guidance into practice because delirium care is complex and involves lots of different people, including family, friends and health professionals.

What have we already done?

We have designed a way to help hospices to overcome these difficulties and follow delirium guidelines better. We have tested this on a small scale and shown that we can collect information we need from patients’ notes and hospice staff in a reliable and timely way.

What we plan to do

What do we want to achieve?

We are now ready to run a major, national trial to test whether this improves delirium care and reduces delirium in hospices. We want to improve the quality of life of the 28,000 people in the UK each year who have delirium whilst in a hospice. We also want to improve the wellbeing of the 112,000 carers (family and friends) who witness the damaging effects of delirium on their loved ones.

How will we do this?

1.Compare what happens when 10 hospices test our new approach, alongside 10 hospices who continue their normal ways of working

2.Assess the cost-effectiveness of our approach

3.Look at how our approach works in different hospices and what makes it work well

4.Explore how to adapt our approach for use in different settings, such as care homes and people’s own homes

What does this mean for me?

If patients and their carers choose not to opt-out of this study, a researcher will look at their patient’s medical records. The researcher will check the records to find out about any delirium episodes and how they were managed. During the study, patients and their carers will also have the chance to talk with the researcher about the care they received, their experience with delirium, and how it affected them.

Chief Investigator

Mark Pearson Professor in Implementation Science - Wolfson Palliative Care Research Centre, University of Hull
Fliss Murtagh Professor in Palliative Care - Wolfson Palliative Care Research Centre, University of Hull

HHTU Study team

Grant Constable - Trial Manager
Phil Best - Data Manager
Judith Cohen - HHTU Director

Collaborators

Dr Gillian Jackson Research Fellow Lead- Wolfson Palliative Care Research Centre, University of Hull
Miriam Johnson Professor in Palliative Care - Wolfson Palliative Care Research Centre, University of Hull
Alicia O'Cathain Professor of Health Services Research - School of Medicine and Population Health, University of Sheffield
Dr Dan Harman Consultant Community Geriatrician - City Health Care Partnership CIC
Dr Peter May Senior Lecturer in Health Economics - King’s College London
Annmarie Hosie Associate Professor, Palliative Care Nursing - University of Notre Dame Australia
Meera Agar Professor of Palliative Medicine - University of Technology Sydney
Mrs Julie Halliwell - Public co-investigator
Dr Paul Taylor St Luke's Senior Clinical Lecturer in Palliative Medicine - Sheffield
Helen Roberts Patient and Public Involvement Coordinator - University of Hull
Dr Chao Huang Hull Health Trials Unit Allam Medical Building - University of Hull

Email address

Delirium@hyms.ac.uk

Participating Sites and their Project Investigators

To be confirmed

To be approved.

 

Watch this space.

Collaborators