Clinical decision support system and incidence of delirium in cognitively impaired older adults transferred to intensive care

Babar Khan, Enrique Calvo-Ayala, Noll Campbell, Anthony Perkins, Ruxandra Ionescu, Jason Tricker, Tiffany Campbell, Mohammed Zawahiri, John D. Buckley, Mark O. Farber, Malaz Boustani

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Elderly patients with cognitive impairment are at increased risk of developing delirium, especially in the intensive care unit. Objective: To evaluate the efficacy of a computer-based clinical decision support system that recommends consulting a geriatrician and discontinuing use of urinary catheters, physical restraints, and unnecessary anticholinergic drugs in reducing the incidence of delirium. Methods: Data for a subgroup of patients enrolled in a large clinical trial who were transferred to the intensive care units of a tertiary-care, urban public hospital in Indianapolis were analyzed. Data were collected on frequency of orders for consultation with a geriatrician; discontinuation of urinary catheterization, physical restraints, or anticholinergic drugs; and the incidence of delirium. Results: The sample consisted of 60 adults with cognitive impairment. Mean age was 74.6 years; 45% were African American, and 52% were women. No differences were detected between the intervention and the control groups in orders for consultation with a geriatrician (33% vs 40%; P = .79) or for discontinuation of urinary catheters (72% vs 76%; P = .99), physical restraints (12% vs 0%; P=.47), or anticholinergic drugs (67% vs 36%; P=.37). The 2 groups did not differ in the incidence of delirium (27% vs 29%; P = .85). Conclusion: Use of a computer-based clinical decision support system may not be effective in changing prescribing patterns or in decreasing the incidence of delirium. (American Journal of Critical Care. 2013;22:257-262).

Original languageEnglish
Pages (from-to)257-262
Number of pages6
JournalAmerican Journal of Critical Care
Volume22
Issue number3
DOIs
StatePublished - May 2013

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Clinical Decision Support Systems
Delirium
Critical Care
Physical Restraint
Cholinergic Antagonists
Incidence
Urinary Catheters
Intensive Care Units
Referral and Consultation
Pharmaceutical Preparations
Urinary Catheterization
Public Hospitals
Urban Hospitals
Tertiary Healthcare
African Americans
Clinical Trials
Control Groups
Geriatricians

ASJC Scopus subject areas

  • Critical Care

Cite this

Clinical decision support system and incidence of delirium in cognitively impaired older adults transferred to intensive care. / Khan, Babar; Calvo-Ayala, Enrique; Campbell, Noll; Perkins, Anthony; Ionescu, Ruxandra; Tricker, Jason; Campbell, Tiffany; Zawahiri, Mohammed; Buckley, John D.; Farber, Mark O.; Boustani, Malaz.

In: American Journal of Critical Care, Vol. 22, No. 3, 05.2013, p. 257-262.

Research output: Contribution to journalArticle

Khan, B, Calvo-Ayala, E, Campbell, N, Perkins, A, Ionescu, R, Tricker, J, Campbell, T, Zawahiri, M, Buckley, JD, Farber, MO & Boustani, M 2013, 'Clinical decision support system and incidence of delirium in cognitively impaired older adults transferred to intensive care', American Journal of Critical Care, vol. 22, no. 3, pp. 257-262. https://doi.org/10.4037/ajcc2013447
Khan, Babar ; Calvo-Ayala, Enrique ; Campbell, Noll ; Perkins, Anthony ; Ionescu, Ruxandra ; Tricker, Jason ; Campbell, Tiffany ; Zawahiri, Mohammed ; Buckley, John D. ; Farber, Mark O. ; Boustani, Malaz. / Clinical decision support system and incidence of delirium in cognitively impaired older adults transferred to intensive care. In: American Journal of Critical Care. 2013 ; Vol. 22, No. 3. pp. 257-262.
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