Nonpharmacological interventions for preventing delirium in adult patients with cancer: a systematic review and meta-analysis
Abstract
Purpose: To determine whether nonpharmacological interventions reduce delirium incidence in adult patients with cancer and to identify effective intervention strategies.
Method: We conducted a systematic review and meta-analysis following PRISMA guidelines. PubMed, CENTRAL, CINAHL, and Ichushi-Web were searched through September 30, 2024, for randomized controlled trials (RCTs). Two authors independently extracted data, assessed the risk of bias using the Cochrane Risk of Bias 2 tool, and evaluated the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. The primary outcome was delirium incidence. A random-effects model was used for the meta-analysis. The study protocol was registered with UMIN-CTR (No. UMIN000051804; registered August 2, 2023).
Results: Overall, 12 RCTs involving 2,747 patients were included. Interventions were categorized into multicomponent interventions, bright light therapy, rehabilitation, and anesthesia or oxygen management. The meta-analysis of five trials showed that multicomponent interventions significantly reduced delirium incidence (risk ratio [RR], 0.43; 95% confidence interval [CI], 0.31-0.60; moderate-certainty evidence), with benefit predominantly observed in postoperative settings. The evidence for bright light therapy was inconclusive (RR, 0.31; 95%CI, 0.07-1.31; very low-certainty evidence). Most of the included studies had concerns regarding the risk of bias, mainly due to a lack of…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,747 participants or records.
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