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Adult nursing
ITU patients with delirium did not benefit from electronic and pharmacist support encouraging the deprescribing of benzodiazepines and anticholinergics
  1. Juliet Donaghy
  1. Emergency Assessment Unit, Ipswich Hospital NHS Trust, Ipswich, UK
  1. Correspondence to Juliet Donaghy, Emergency Assessment Unit, Ipswich Hospital NHS Trust, Ipswich IP4 5PD, UK; juliet.a.donaghy{at}gmail.com

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Commentary on: D. Campbell, N. L. Perkins, A.J. Khan, et al. Deprescribing in the Pharmacologic Management of Delirium: A Randomized Trial in the Intensive Care Unit. J Am Geriatr Soc 2019;67(4):695–702.

Implications for practice and research

  • Electronic alerts were used with pharmacist support to suggest alternative medications to benzodiazepines and anticholinergics. This had no effect on the use of these medications or the short-term patient outcomes.

  • Deprescribing interventions can have little influence where prescribing levels are already very low.

Context

Delirium is a syndrome characterised by an acute onset of disturbed consciousness, cognitive function or perception. It is associated with higher mortality, increased rates of dementia and longer hospital stays.1 Consequently, establishing methods of prevention has been identified as an important goal.1 Delirium is a common issue, affecting one-third of hospitalised general medical patients aged 70 and over.2 Campbell et al argue that anticholinergics and benzodiazepines cause neurotransmitter imbalances (specifically cholinergic deficiency, dopaminergic and …

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