An innovative post-hospital model of care (DDEFY Delirium): A pilot randomized trial

ABSTRACT

Presents a study which aims to examine an innovative post-hospital model of care. The study developed a model of care for those who had delirium in the hospital and then transitioned home, known as DDEFY Delirium. This pilot study aimed to assess the implementation of this novel model of care and determine the ability to recruit patients. This pilot randomized controlled trial was conducted between August 2019 and December 2020. Patients aged >=65 years, treated by inpatient geriatric consultative service for delirium and discharged home, were randomized into control or intervention (and later on a virtual group due to COVID-19). Once determined eligible, the DDEFY Delirium intervention was implemented. DDEFY is used to describe the five pillars that form our conceptual model (1) Diagnose cognitive disorder;(2) review Drugs;(3) Educate patient and family;(4) assess and treat Function (al) decline;(5) Your (patient's and family's) health goals. For the intervention groups, participants were asked about their caregivers, asked to perform cognitive and functional assessments, and discussed goals of care. Outcomes of interest included recruitment rate, adherence, attrition, and study team participation. Both the in-person and virtual intervention groups had 100% adherence to pillars 2 and 4. Lowest adherence was to pillars 1 (virtual = 75%) and 5 (in-person = 71%;virtual = 75%). For both the in-person and virtual intervention groups, attrition was zero and study team participation was 100%. In this pilot study, we assessed patients in their homes, after experiencing delirium during and after their hospital admission. Even though the recruitment rate was affected by COVID-19, it was higher than anticipated as was the adherence to the intervention. (PsycInfo Database Record (c) 2022 APA, all rights reserved)