Survey of psychiatrists and psychiatry residents in Colombia about their preventive and therapeutic practices in delirium

Rev Colomb Psiquiatr (Engl Ed). 2020 May 28:S0034-7450(20)30031-7. doi: 10.1016/j.rcp.2020.02.003. Online ahead of print.
[Article in English, Spanish]

Abstract

Objective: To describe pharmacological and non-pharmacological practices for delirium, carried out by psychiatry residents and psychiatrists in Colombia.

Methods: An anonymous survey was conducted based on the consensus of experts of the Liaison Psychiatry Committee of the Asociación Colombiana de Psiquiatría [Colombian Psychiatric Association] and on the literature review. It was sent by email to the association members.

Results: 101 clinicians participated. Non-pharmacological preventive measures such as psychoeducation, correction of sensory problems or sleep hygiene are performed by 70% or more. Only about 1 in 10 participants are part of an institutional multi-component prevention programme. The preventive prescription of drugs was less than 20%. Regarding non-pharmacological treatment, more than 75% recommend correction of sensory difficulties, control of stimuli and reorientation. None of the participants indicated that the care at their centres is organised to enhance non-pharmacological treatment. 17.8% do not use medication in the treatment of delirium. Those who use it prefer haloperidol or quetiapine, particularly in hyperactive or mixed motor subtypes.

Conclusions: The practices of the respondents coincide with those of other experts around the world. In general, non-pharmacological actions are individual initiatives, which demonstrates the need in Colombian health institutions to commit to addressing delirium, in particular when its prevalence and consequences are indicators of quality of care.

Keywords: Antipsicóticos; Antipsychotics; Calidad de la atención de salud; Delirio; Delirium; Educación en salud; Health education; Prevención primaria; Primary prevention; Quality of health care; Terapéutica; Therapeutics.