Nonpharmacological Interventions Prevent Delirium in Older Adult Surgical Patients: A Network Meta-Analysis of Randomized Controlled Trials.

PURPOSE: The current meta-analysis aimed to evaluate the effectiveness of nonpharmacological interventions in preventing delirium among older adult surgical patients.

METHOD: Randomized controlled trials (RCTs) examining nonpharmacological approaches were selected. A meta-analysis was performed using random-effect models to calculate standard mean differences and 95% confidence intervals (CI).

FINDINGS: Twelve RCTs (N = 3,829) met inclusion criteria. Nonpharmacological interventions significantly reduced delirium incidence (OR [odds ratio] = 0.57, 95% CI [0.49, 0.66]). Multicomponent (OR = 0.6, 95% CI [0.49, 0.75]) and single-component (OR = 0.53, 95% CI [0.42, 0.66]) interventions were effective. Network meta-analysis revealed that the multicomponent intervention "Family HELP" demonstrated significant superiority over four other interventions (OR = 0.11, 95% CI [0.04, 0.33]; p-score = 0.911).

CONCLUSION

Nonpharmacological interventions were found to effectively prevent delirium among older adult surgical patients, with the Family HELP intervention being the most effective. These interventions should be integrated into nursing care guidelines to enhance patient-centered care and experience.