Abstract
Aim: The aim of this paper is to present the findings of an integrative literature review of the evidence for the clinical management of delirium in patients with advanced cancer.
Background: Patients with advanced cancer frequently experience delirium which can be distressing for both patients and their families. Current guidelines recommend that underlying causes of the delirium be addressed and a course of antipsychotics considered. However the research into the effectiveness of treatments for delirium in people with advanced cancer is limited.
Design: Integrative literature review
Data sources: Systematic searches of the MEDLINE, CINAHL, ProQuest Nursing and Allied Health and PsychInfo databases were conducted in April 2016 to include papers published in 2000 and later. The returns were screened using inclusion and exclusion criteria and the seven studies found to be
suitable were subject to review.
Review Methods: Findings of the seven papers were extracted, appraised critically and reviewed using a narrative approach.
Results: A number of interventions, including the use of atypical antipsychotics, opioid rotation, methylphenidate hydrochloride and celiac plexus block were reported however there was limited evidence of their effectiveness. One study reported the use of exercise therapy as a nonpharmacological intervention.
Conclusion: A variety of interventions to treat delirium in patients with advanced cancer have been tested through non-blinded, non-randomised trials which has not produced a clear evidence-base for practice. There is a need for further research (particularly randomised control trials) to determine the most effective treatments for patients with advanced cancer experiencing delirium.
Background: Patients with advanced cancer frequently experience delirium which can be distressing for both patients and their families. Current guidelines recommend that underlying causes of the delirium be addressed and a course of antipsychotics considered. However the research into the effectiveness of treatments for delirium in people with advanced cancer is limited.
Design: Integrative literature review
Data sources: Systematic searches of the MEDLINE, CINAHL, ProQuest Nursing and Allied Health and PsychInfo databases were conducted in April 2016 to include papers published in 2000 and later. The returns were screened using inclusion and exclusion criteria and the seven studies found to be
suitable were subject to review.
Review Methods: Findings of the seven papers were extracted, appraised critically and reviewed using a narrative approach.
Results: A number of interventions, including the use of atypical antipsychotics, opioid rotation, methylphenidate hydrochloride and celiac plexus block were reported however there was limited evidence of their effectiveness. One study reported the use of exercise therapy as a nonpharmacological intervention.
Conclusion: A variety of interventions to treat delirium in patients with advanced cancer have been tested through non-blinded, non-randomised trials which has not produced a clear evidence-base for practice. There is a need for further research (particularly randomised control trials) to determine the most effective treatments for patients with advanced cancer experiencing delirium.
| Original language | English |
|---|---|
| Pages (from-to) | 4172-4183 |
| Journal | Journal of Clinical Nursing |
| Volume | 26 |
| Issue number | 23-24 |
| Early online date | 30 Aug 2017 |
| DOIs | |
| Publication status | Published - 28 Nov 2017 |
Keywords
- literature review
- delirium
- palliative care
- end of life
- advanced cancer
- neoplasm
- management
- nursing
Access to Document
- Lawley_&_Hewison_An_integrative_literature_review_Journal_of_Clinical_Nursing_2017
This is the peer reviewed version of the following article: Lawley H, Hewison A. An integrative literature review exploring the clinical management of delirium in patients with advanced cancer. J Clin Nurs. 2017;00:1–12. https://doi.org/10.1111/jocn.13960, which has been published in final form at 10.1111/jocn.13960. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.