An integrative literature review exploring the clinical management of delirium in patients with advanced cancer

Hayley Lawley, Alistair Hewison

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)
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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.
Original languageEnglish
Pages (from-to)4172-4183
JournalJournal of Clinical Nursing
Issue number23-24
Early online date30 Aug 2017
Publication statusPublished - 28 Nov 2017


  • literature review
  • delirium
  • palliative care
  • end of life
  • advanced cancer
  • neoplasm
  • management
  • nursing


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