Del-COrS LTC

Development of a core outcome set for effectiveness trials of interventions to

prevent and/or treat delirium in long-term care (Del-COrS LTC).

http://www.comet-initiative.org/studies/details/796?result=true

Overview of the Project

Delirium is a common, serious, and potentially preventable condition with devastating impact on the quality of life, which has led to numerous intervention trials. To help patients, doctors and other health professionals make decisions about treatments, we need evidence about what works best. Treatments are developed and tested by researchers to make sure they work and are safe. To do this, researchers need to look at the effects those treatments have on patients. Researchers do this by measuring an ‘outcome’.

If two studies are looking at treatment for the same condition (delirium) but are looking at different outcomes, then we cannot compare or combine results. If all studies in a particular health condition used the same outcomes, they could all be compared and combined. This would reduce waste by making best use of all the research. When a set of main outcomes has been agreed for a health condition, it’s called a ‘core outcome set’. This study aims to develop international agreement on a core outcome set for research studies to either prevent or treat delirium in long-term care.

A core outcome set is an agreed standardised set of outcomes that should be measured and reported, as a minimum, in all clinical trials in specific areas of health or health care. This helps in combining results in meta-analyses and identifying important areas in clinical practice. This study seeks to develop international agreement on a core outcome set for research studies to either prevent or treat delirium in long-term care.

Aims of the study:

This study is part of a bigger project aiming to develop Core Outcome Set for Delirium. There are four studies in this project carried out in different settings: hospital wards, intensive care units, palliative care and long-term care. This study aims to develop a core outcome set for effectiveness trials of interventions to prevent and/or treat delirium in long-term care.

Methods

Systematic literature review

We have completed a systematic literature review examining the evidence base to establish existing study outcomes for studies of interventions to prevent or treat delirium. It has been published in Age and Ageing.

https://academic.oup.com/ageing/article-abstract/51/11/afac267/6834146

Interviews

We completed one-to-one interviews with relatives of delirium survivors and professionals who encounter delirium in long term care settings. Together with the findings of the systematic review this has given us a list of candidate outcomes for possible inclusion included in the core outcome set.

Delphi Survey & Consensus workshop

We conducted a Delphi survey to establish which candidate outcomes stakeholders consider the most important. The survey consisted of two rounds. Participants included:

1. Expert clinicians (including but not limited to physicians, nurses and allied health professionals- and including staff working in long term care settings)

2. Trialists/researchers working in the field of delirium treatment or prevention

3. Survivors of delirium living in long term care, family members of long-term care residents, and patient user/support group representatives

We also conducted international consensus workshops to finalise which outcomes will be included in the core outcome set. This will then be published and can support future trials in this area.