Expert opinions on the first-line pharmacological treatment for delirium in Japan: a conjoint analysis

Okumura, Yasuyuki; Hatta, Kotaro; Wada, Ken; Takeuchi, Takashi; Kishi, Yasuhiro

doi:10.1017/s1041610215002446

Cited by 11 publications

(8 citation statements)

References 26 publications

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“…The outcomes are similar to those from a recent database study in Japan, where haloperidol infusion was the most frequently used treatment in postoperative patients with delirium 17. These results are also consistent with those of a questionnaire-based cross-sectional study in which more than two-thirds of Japanese experts recommended intravenous haloperidol as the initial drug (if an intravenous line was placed during hospitalisation) and atypical oral antipsychotics such as risperidone or quetiapine as initial oral drugs for hyperactive delirium 42. Risperidone solution and olanzapine orodispersible tablets could be useful for patients who have difficulties in taking medicines 16.…”

Section: Discussionsupporting

confidence: 88%

“… 17 These results are also consistent with those of a questionnaire-based cross-sectional study in which more than two-thirds of Japanese experts recommended intravenous haloperidol as the initial drug (if an intravenous line was placed during hospitalisation) and atypical oral antipsychotics such as risperidone or quetiapine as initial oral drugs for hyperactive delirium. 42 Risperidone solution and olanzapine orodispersible tablets could be useful for patients who have difficulties in taking medicines. 16 In our study, a relatively high proportion of patients were prescribed risperidone solution (23.6%); however, only 0.6% were prescribed olanzapine orodispersible tablets.…”

Section: Discussionmentioning

confidence: 99%

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Demographic and clinical characteristics of patients with delirium: analysis of a nationwide Japanese medical database

et al. 2022

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ObjectivesDelirium commonly occurs during hospitalisation and is associated with increased mortality, especially in elderly patients. This study aimed to determine the demographic and clinical characteristics of patients with delirium in the Japanese real-world clinical setting using a nationwide database comprising claims and discharge abstract data.DesignThis was an observational, cross-sectional, retrospective study in hospitalised patients with an incident delirium identified by a diagnosis based on International Classification of Diseases, 10th Revision codes or initiating antipsychotics recommended for delirium treatment in Japan during their hospitalisation.SettingPatients from the Medical Data Vision database including more than 400 acute care hospitals in Japan were evaluated from admission to discharge.ParticipantsOf the 32 910 227 patients who were included in the database between April 2012 and September 2020, a total of 145 219 patients met the criteria for delirium.Primary and secondary outcome measuresDemographic and baseline characteristics, comorbidities, clinical profiles and pharmacological treatments were evaluated in patients with delirium.ResultsThe mean (SD) patient age was 76.5 (13.8) years. More than half of the patients (n=82 159; 56.6%) were male. The most frequent comorbidities were circulatory system diseases, observed in 81 954 (56.4%) patients. Potentially inappropriate medications (PIMs) with risk of delirium including benzodiazepines and opioids were prescribed to 76 798 (52.9%) patients. Approximately three-fourths of these patients (56 949; 74.2%) were prescribed ≥4 PIMs. The most prescribed treatment for delirium was injectable haloperidol (n=82 490; 56.8%). Mean (SD) length of hospitalisation was 16.0 (12.1) days.ConclusionsThe study results provide comprehensive details of the clinical characteristics of patients with delirium and treatment patterns with antipsychotics in the Japanese acute care setting. In this patient population, the prescription rate of injectable haloperidol and PIMs was high, suggesting the need for improved understanding among healthcare providers about the appropriate management of delirium, which may benefit patients.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Demographic and clinical characteristics of patients with delirium: analysis of a nationwide Japanese medical database

et al. 2022

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“…The results of this analysis support this. For hypoactive delirium treatment, some experts recommend the use of Aripiprazole, Mianserin, and Trazodone [24]. Compared to hyperactive delirium, there is insufficient evidence regarding the use of drugs to treat hypoactive delirium [26].…”

Section: Discussionmentioning

confidence: 99%

Drug Treatment for Patients with Postoperative Delirium and Consultation-Liaison Psychiatry in Japan: A Retrospective Observational Study of a Nationwide Hospital Claims Database

et al. 2021

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A BSTRA CT BACKGROUND Delirium is the most commonly experienced disorder in consultation liaisons. There are currently research and guidelines in Japan for delirium treatment. Still, there is no retrospective observational study of consultation-liaison psychiatry (CLP) and antipsychotic-centered drugs. This study aims to examine CLP's effectiveness and drug treatment. METHODS Using a Japanese national inpatient database of 2016 and 2017, we investigated the presence or absence of CLP for the treatment of delirium in postoperative delirium patients, the status of drug selection, delirium days, and the average days from surgery to discharge. We examined factors affecting days from surgery to discharge using multiple linear regression analysis. RESULTSThis study was classified into a CLP group (n = 1,142) and a non-CLP group (n = 11,355). The days from surgery to discharge in the CLP and non-CLP groups was 16.7 and 17.1, respectively (p = 0.3613). There was a significant difference in the delirium days between the CLP and non-CLP groups (8.9 vs. 7.4; p < 0.00001). Haloperidol infusion was frequently used between the days from surgery to first day of delirium. It was prescribed less often than other oral drugs. Multiple regression analysis identified an association between age, men, CCI1-2, CCI ≥3, number of drugs used, days from surgery to first day of delirium, and early CLP (0-2days) with days from surgery to discharge. CONCLUSIONSWe investigated the effectiveness of CLP and the actual conditions of pharmacotherapy for postoperative delirium. Our findings suggest that early CLP may be associated with shorter days from surgery to discharge.

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“…CA has been applied in healthcare fields ranging from mental health31 to chronic leukaemia,32 and has been used specifically within the field of IBD 19–21. The methodology of using conjoint trade-off analysis embedded within a RAND panel is to the best of our knowledge a novel approach.…”

Section: Discussionmentioning

confidence: 99%

Development of an index to define overall disease severity in IBD

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Expert opinions on the first-line pharmacological treatment for delirium in Japan: a conjoint analysis

Cited by 11 publications

References 26 publications

Demographic and clinical characteristics of patients with delirium: analysis of a nationwide Japanese medical database

Demographic and clinical characteristics of patients with delirium: analysis of a nationwide Japanese medical database

Drug Treatment for Patients with Postoperative Delirium and Consultation-Liaison Psychiatry in Japan: A Retrospective Observational Study of a Nationwide Hospital Claims Database

Development of an index to define overall disease severity in IBD

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