Evidence map›Paper›PMID 38667518›Full record

ReviewGeriatrics (Basel, Switzerland)2024

Pharmacological Treatment for Terminal Agitation, Delirium and Anxiety in Frail Older Patients.

Dine A D Jennes, Tim Biesbrouck, Maaike L De Roo, Tinne Smets, Nele Van Den Noortgate

Open access · goldAbstract readReview
In one paragraph

Review in Geriatrics (Basel, Switzerland), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.7field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Dine A D JennesDepartment of Geriatric Medicine, Antwerp University Hospital, 2650 Edegem, Belgium.ORCID 0009-0004-2714-2014
Tim BiesbrouckDepartment of Geriatric Medicine, University Hospitals Leuven, 3000 Leuven, Belgium.ORCID 0000-0001-5117-1027
Maaike L De RooDepartment of Geriatric Medicine, University Hospitals Leuven, 3000 Leuven, Belgium.ORCID 0000-0002-2972-0867
Tinne SmetsEnd-of-Life Care Research Group, Vrije Universiteit Brussel [VUB] and Ghent University, 1090 Brussels, Belgium.
Nele Van Den NoortgateEnd-of-Life Care Research Group, Vrije Universiteit Brussel [VUB] and Ghent University, 1090 Brussels, Belgium.ORCID 0000-0001-5546-5380
KU Leuven · BEVrije Universiteit Brussel · BEAntwerp University Hospital · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

contextPsychological distress symptoms in the last days of life often contribute to the overall symptom burden in frail older patients. Good symptom management practices are crucial to ensure high-quality end-of-life care in an aging population, though the best pharmacological approach to treat these psychological symptoms has yet to be established.

objectivesTo identify current evidence-based and practice-based knowledge of pharmacological interventions for the treatment of agitation, delirium, and anxiety during the last days of life in frail older patients.

methodsA systematic, mixed methods review was performed through MEDLINE via PubMed and EMBASE from inception until February 2022 and updated through March 2023. National and international guideline databases and grey literature were searched for additional studies and guidelines.

resultsFour quantitative studies, two non-randomized and two descriptive, were identified. No randomized controlled trials met inclusion criteria. No qualitative studies were withheld. The three consensus-based protocols that were found through citation searching and screening of grey literature did not meet the standards for inclusion. Haloperidol is recommended in consensus-based guidelines for delirium and is widely used, but high-quality evidence about its efficacy is missing. Better control of agitation or refractory delirium might be achieved with the addition of a benzodiazepine. There is no evidence available about the treatment of anxiety in the last days of life in frail older patients.

conclusionsThis mixed methods review demonstrates the lack of good quality evidence that is needed to help clinicians with pharmacological treatment decisions when confronted with psychological symptoms in the last days of life in frail older patients. Population aging will only emphasize the need for further research in this specific population.

Indexed as

anxietyconfusiondeliriumfrailtyreviewterminal care

Identifiers

PMID38667518
PMCPMC11050185
OpenAlexW4394932509

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.