Expert consensus on research priorities for the prevention of delirium in adult ICU patients

Abstract

Objective: To identify research priorities for the prevention of delirium in adult intensive care unit (ICU) patients. Research Methodology: We conducted an iterative, consensus-based modified Delphi methodology combined with initial literature search to establish a prioritized research agenda. As a first round of an anonymised modified Delphi procedure, a 10-member international expert panel, selected on basis of their academic and clinical expertise, were asked to add topics they perceived missing from a list of potential research gaps regarding ICU delirium prevention. In the second round, experts rated each topic research priority using a 4-point Likert scale (very low to very high). Topics were considered a research priority if rated ‘high’ or ‘very high’ by at least 80% of experts. A third round to establish a top 3 was planned if more than 10 priorities were identified. Main Outcome measures: Research priorities for delirium prevention in adult ICU patients. Results: The evidence-based list comprised 44 potential research priorities with experts suggesting 9 additional topics. Of the 53 potential research priorities, 8 were unanimously rated as research priorities: ‘early mobilization’, ‘exercise interventions’, ‘sedation breaks for ventilator weaning’, ‘routine delirium surveillance’, ‘cognitive training/exercise’, ‘reducing light, noise, and care activities at night’, ‘open visiting hours’, and ‘family participation’. Conclusions: We have identified 8 research priorities for delirium prevention in adult ICU patients. Implications for Clinical Practice: The research agenda developed in this study provides direction for future investigations into delirium prevention in ICU patients. By highlighting expert-endorsed priorities, it supports a more focused allocation of research efforts and funding. The findings may inform the development of targeted, evidence-based prevention strategies, ultimately contributing to improved clinical outcomes in critical care settings.