Optimization of Delirium Care in Adult Patients with Cancer: A Comprehensive and Integrative Review of Efficacy and Patient Outcomes

World Journal of Clinical Medicine Research | Vol 4, Issue 1

Table 4. Synopsis of Eligible Studies for the Review

Author(s), Year & Country	Title	Aim	Design	Sampling and sample size	Findings	Clinical Relevance
Mercadante et al., 2018.Italy [41]	Prevalence of delirium in advanced cancer patients in home care and hospice and outcomes after 1 week of palliative care	To determine the prevalence of delirium in advanced cancer patients receiving palliative care and its outcomes after 1 week of intervention	Quantitative study; cross-sectional study. Data analysis: Descriptive statistics and logistic regression analysis	Convenience sampling, 329 patients	Delirium prevalence was 17.5% and decreased to 10.3% after 1 week of palliative care intervention - Palliative care is associated with a reduction in the incidence and severity of delirium.Delirium in hospitalized cancer patients generally reversible - Improvements observed with palliative care interventions, antipsychotic medications, and exercise therapy.	Palliative care intervention can improve delirium outcomes in advanced cancer patients

De La Cruz et al., 2015USA [11]	The frequency, characteristics, and outcomes among cancer patients with delirium admitted to an acute palliative care unit	To describe the frequency, characteristics, and outcomes of cancer patients with delirium admitted to an acute palliative care unit	Quantitative study. Data analysis: descriptive statistics	Convenience sampling, 3,231 patients with advanced cancer	Delirium was present in 10.3% of patients admitted to the palliative care unit	Delirium is a common issue among cancer patients in the palliative care setting

Chishi et al., 2023India [10]	Prevalence of Delirium in Advance Cancer Patients Admitted in Hospice Centre and Outcome after Palliative Intervention	To determine the prevalence of delirium in advanced cancer patients admitted to a hospice centre and its outcome after palliative intervention	Quantitative study; cross-sectional study. Data analysis: descriptive statistics and logistics regression analysis	Convenience sampling, 270 patients	Delirium prevalence was 24.1%, and it improved after palliative intervention.Addressing the physical, emotional, and spiritual needs of the patient showed positive impacts - Incorporating palliative care interventions may be effective in managing delirium.Delirium in hospitalized cancer patients generally reversible - Improvements observed with palliative care interventions, antipsychotic medications, and exercise therapy	Palliative care intervention can improve delirium outcomes in advanced cancer patients admitted to hospice centres

Okuyama et al., 2019Japan [45]	Current pharmacotherapy does not improve the severity of hypoactive delirium in patients with advanced cancer: pharmacological audit study of safety and efficacy in real-world (phase‐R)	To assess the efficacy of current pharmacotherapy in managing hypoactive delirium in advanced cancer patients	Quantitative study. Data analysis: descriptive statistics	Convenience sampling, 548 patients	Current pharmacotherapy did not improve the severity of hypoactive delirium in advanced cancer patients	Current pharmacotherapy may not be effective in managing hypoactive delirium in advanced cancer patients

Agar et al., 2017Australia [1]	Efficacy of oral risperidone, haloperidol, or placebo for symptoms of delirium among patients in palliative care: a randomized clinical trial	To assess the efficacy of oral risperidone, haloperidol, or placebo in managing symptoms of delirium in patients receiving palliative care	Randomized clinical trial Data analysis: Descriptive statistics, chi-square tests, and regression analysis	Stratified random sampling, 247 patients	Oral risperidone and haloperidol were not superior to placebo in managing symptoms of delirium in patients receiving palliative care	Oral risperidone and haloperidol may not be effective in managing symptoms of delirium in patients receiving palliative care

Maeda et al., 2020Japan [39]	Safety and effectiveness of antipsychotic medication for delirium in patients with advanced cancer: A large-scale multicentre prospective observational study in real-world palliative care settings	To evaluate the safety and effectiveness of antipsychotic medication for delirium in patients with advanced cancer in real-world palliative care settings	Quantitative method Data analysis: Descriptive statistics and logistic regression analysis	Convenience sampling, 583 patients	Antipsychotic medication was safe and effective in managing delirium in patients with advanced cancer in real-world palliative care settingsAntipsychotic medication was generally well-tolerated by patients	The study concludes that antipsychotic medication is a useful treatment option for managing delirium in these patients, but careful monitoring is necessary to prevent potential adverse effects, particularly in patients with pre-existing cardiovascular and neurological conditions

Tatematsu et al., 2011Japan [48]	The effects of exercise therapy on delirium in cancer patients: a retrospective study	To investigate the effects of exercise therapy on delirium in cancer patients	Quantitative study. Data analysis: descriptive statistics	Consecutive sampling Patients with delirium (n=31) &without delirium (n=43)	Exercise therapy was associated with a significantly lower incidence of delirium in cancer patients (p<0.05)	Exercise therapy may be a useful intervention for preventing delirium in cancer patients.

Matsuda et al. 2020Japan [40]	Reversibility of delirium in ill‐hospitalized cancer patients: Does underlying etiology matter?	To investigate the reversibility of delirium in hospitalized cancer patients and to evaluate the impact of the underlying aetiology on delirium reversibility	Quantitativestudy; cross-sectional study. Data analysis: descriptive statistics and logistics regression analysis	Consecutive sampling Participants were 169 hospitalized cancer patients with delirium.	Delirium reversed in 60.9% of patients, and the reversibility rate was higher in patients with reversible aetiologies (66.3%) than in those with irreversible aetiologies (37.9%).Multicomponent interventions involving non-pharmacological approaches were effective - Environmental modifications reduced the severity and duration of delirium.Delirium in hospitalized cancer patients generally reversible - Improvements observed with palliative care interventions, antipsychotic medications, and exercise therapy.- Delirium reversibility rate may vary depending on the underlying etiology - Identifying and managing underlying etiologies crucial in improving delirium outcomes	The study suggests that delirium in hospitalized cancer patients is reversible in the majority of cases, but the reversibility rate may vary depending on the underlying aetiology.Identification and management of underlying aetiologies may improve delirium outcomes in these patients.