DAMPen-D

This study led the way in improving the detection, assessment, management and prevention of delirium in specialist palliative care units.

It assessed the feasibility of using an implementation strategy to enable guideline-adherent delirium care in hospices with the aim of reducing patient days with delirium.

The study conducted the following:

1. Co-design of a flexible implementation strategy, drawing on the Creating Learning Environments for Collaborative Care (CLECC), for use in Specialist Palliative Care Units (CLECC-SPCU)
2. Exploration of the feasibility of a future effectiveness evaluation study of CLECC-SPCU supported delirium care on clinical outcomes
3. Assessing the acceptability and flexibility of the co-designed CLECC-SPCU in three SPCUs

The Detection, Assessment, Management, and Prevention of Delirium (DAMPen-D) feasibility study concluded in February 2023.

Across three hospices, implementation of the CLECC-Pal Delirium strategy was feasible to deliver and evaluate using routine clinical records (n = 300 admissions, pre/post).

Evidence of post implementation guideline-adherent care improved: Clinician recorded delirium diagnosis increased from 15% to 28%, documented delirium risk assessment rom 0% to 16%, and admission delirium screening using the 4AT from 7% to 35%. Among patients who experienced delirium, we observed a 6% absolute reduction in the proportion of in-patient days with delirium.

Outputs

Published protocol for DAMPen-Delirium study

Results of the DAMPen-Delirium Feasibility study

Work package 1, Co-design, and work package 3, Process Evaluation will be published here in due course.

DAMPen-Delirium II

The findings from DAMPen-Delirium feasibility study supported further investigation in a fully powered trial, leading to the NIHR funded four year DAMPen-Delirium II cluster RCT, which will evaluate CLECC-Pal Delirium at scale in 20 palliative care units across the United Kingdom.