Comparison of haloperidol, non-haloperidol antipsychotics, and no pharmacotherapy for the management of delirium in an inpatient geriatric palliative care population

Antipsychotics are frequently used for treatment of delirium, although little evidence exists that they improve delirium outcomes. Our objective was to evaluate haloperidol (HAL) compared to non-haloperidol antipsychotics (NHAP) or no pharmacologic treatment (NP) in the management of delirium in old...

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Bibliographic Details
Published in:Journal of pain & palliative care pharmacotherapy 2018-07, Vol.32 (2-3), p.141-148
Main Authors: Felton, Maria A, Jarrett, Jennie B, Hoffmaster, Richard, D'Amico, Frank J, Sakely, Heather, Pruskowski, Jennifer
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Antipsychotic Agents - adverse effects
Antipsychotic Agents - therapeutic use
Delirium - drug therapy
Female
Haloperidol - adverse effects
Haloperidol - therapeutic use
Hospitalization - statistics & numerical data
Humans
Inpatients
Length of Stay
Male
Palliative Care - methods
Regression Analysis
Retrospective Studies
Time Factors
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Summary:Antipsychotics are frequently used for treatment of delirium, although little evidence exists that they improve delirium outcomes. Our objective was to evaluate haloperidol (HAL) compared to non-haloperidol antipsychotics (NHAP) or no pharmacologic treatment (NP) in the management of delirium in older adults under the care of a palliative care consult service across a large, integrated health care system. A retrospective chart review examined data from September 2014-September 2015. All hospitalized patients ≥65 years old with a diagnosis of delirium during palliative care consultation were included (n = 304). Primary outcome was length of stay after delirium diagnosis. Secondary outcomes included delirium symptom length, sedation, and QTc prolongation. Univariate statistical tests, analysis of covariance, and multiple regression methods were used to compare groups. Post-delirium length of stay in the HAL, NHAP, and NP groups were 8.5, 7.0, and 6.8 days, respectively (p = 0.19). Delirium duration in the HAL, NHAP, and NP groups were 6.7, 6.0, and 4.9 days, respectively (p = 0.05). Safety outcomes were statistically different than the reference group (NHAP). Congruent with existing literature in other generalized patient populations, no significant difference in post-delirium length of stay existed in geriatric, palliative care population.
ISSN:1536-0288
1536-0539
DOI:10.1080/15360288.2018.1513434