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NIA Awards R01 to Dr. Boustani for
Pharmacological Management of Delirium Trial
In 2005, approximately 2.7 million Americans aged 65 and older spent at least one day in the intensive care unit costing Medicare a total of $27.5 billion. Up to 80% of these older ICU patients had delirium during their hospital stay. These patients are prone to develop various hospital acquired complications such as falls, injuries, and pressure ulcers that may contribute to mortality, poorer functional status, limited rehabilitation, prolonged length of stay, increased institutionalization, and higher health care costs.
The National Institute on Aging has funded Principal Investigator Malaz Boustani, MD, MPH, for “Pharmacological Management of Delirium,” an R01 that will evaluate the efficacy of a multi-component pharmacological intervention in reducing delirium severity and duration and subsequently decrease ICU and hospital length of stay.
Pharmaco-epidemiological studies and scattered randomized clinical trials have demonstrated that the pharmacological management of delirium among older adults is complicated and may need to include a combination of a reduction in the use of benzodiazepines and anticholinergics, along with the use of low dose neuroleptics such as haloperidol. However, there are no randomized controlled trials that have evaluated the efficacy of such a pharmacological management on reducing delirium severity, duration, and its related complications.
The five-year randomized controlled trial will evaluate the efficacy of a pharmacological protocol that includes a reduction of exposure to anticholinergic medications, a reduction of exposure to benzodiazepines, and daily use of a low dose of haloperidol.
“A major advantage of the proposed individualized multi-component intervention,” notes Dr. Boustani, “is reducing exposure to potentially harmful medications and using a low dose of haloperidol during the critical early days of ICU care.”
July 30, 2010
