Journal of pain and symptom management · 2026
Video Monitoring for Agitated Delirium in Palliative Care: Secondary Analysis of the RECORD Trial.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Min Juleen, De La Rosa Allison, Nelson Bonnie, Chen Minxing, Bruera Eduardo, Hui David
Аннотация
CONTEXT: Video recording facilitates continuous monitoring of patients with agitated delirium, but its role in inpatient palliative care remains unexplored.
OBJECTIVE: This study examined the benefit of video monitoring for assessing persistent agitated delirium in an inpatient palliative supportive care unit (PSCU).
METHODS: This was a prospective observational study as a part of secondary analysis of a multicenter, double-blind, randomized clinical trial examining the proportional sedation for palliative supportive care unit (PSCU) patients with persistent agitated delirium (RECORD trial). The presence or absence of agitation (modified Richmond Agitation-Sedation Scale [RASS] score, ≥+1 vs. ≤0) was documented over 24 hour using various methods (in-person vs. video), observer occupations (registered nurse [RN] vs. physician [MD]), and frequencies (intermittent [every two hours] vs. continuous [every five minute]).
RESULTS: Fourteen patients underwent 227.2 hours of video monitoring (median: 16.2 hour/patient; IQR, 12.4-22.2 hours), including 170 in-person intermittent RN, 109 video intermittent RN, 109 video intermittent MD, and 2445 video continuous MD RASS assessments. Agreement (generalized estimating equations) was 75% between in-person and video intermittent RN RASS assessments, 95% between video intermittent RN and MD RASS assessments, and 73% between video intermittent and continuous MD RASS assessments. Video intermittent RN RASS assessment documented 17 (16%) agitation episodes, whereas in-person RN RASS assessment did not. Also, in-person RN RASS assessment documented 10 (9%) agitation episodes, whereas video intermittent RN RASS assessment did not. Video continuous MD RASS assessment identified 28% more agitation episodes than video intermittent MD RASS assessment and revealed three patterns of agitation (persistent, interval, and intermittent).
CONCLUSION: Our preliminary findings highlight the level of interrater agreement of video monitoring with in-person assessments and its potential advantage to provide higher resolution data and patterns of agitation.
OBJECTIVE: This study examined the benefit of video monitoring for assessing persistent agitated delirium in an inpatient palliative supportive care unit (PSCU).
METHODS: This was a prospective observational study as a part of secondary analysis of a multicenter, double-blind, randomized clinical trial examining the proportional sedation for palliative supportive care unit (PSCU) patients with persistent agitated delirium (RECORD trial). The presence or absence of agitation (modified Richmond Agitation-Sedation Scale [RASS] score, ≥+1 vs. ≤0) was documented over 24 hour using various methods (in-person vs. video), observer occupations (registered nurse [RN] vs. physician [MD]), and frequencies (intermittent [every two hours] vs. continuous [every five minute]).
RESULTS: Fourteen patients underwent 227.2 hours of video monitoring (median: 16.2 hour/patient; IQR, 12.4-22.2 hours), including 170 in-person intermittent RN, 109 video intermittent RN, 109 video intermittent MD, and 2445 video continuous MD RASS assessments. Agreement (generalized estimating equations) was 75% between in-person and video intermittent RN RASS assessments, 95% between video intermittent RN and MD RASS assessments, and 73% between video intermittent and continuous MD RASS assessments. Video intermittent RN RASS assessment documented 17 (16%) agitation episodes, whereas in-person RN RASS assessment did not. Also, in-person RN RASS assessment documented 10 (9%) agitation episodes, whereas video intermittent RN RASS assessment did not. Video continuous MD RASS assessment identified 28% more agitation episodes than video intermittent MD RASS assessment and revealed three patterns of agitation (persistent, interval, and intermittent).
CONCLUSION: Our preliminary findings highlight the level of interrater agreement of video monitoring with in-person assessments and its potential advantage to provide higher resolution data and patterns of agitation.