학술논문
Quality contract ‘prevention of postoperative delirium in the care of elderly patients’ study protocol: a non-randomised, pre–post, monocentric, prospective trial
Document Type
article
Author
Sascha Treskatsch; Claudia Spies; Sophie K Piper; Jochen Kruppa; Felix Balzer; Ursula Marschall; Kathrin Scholtz; Dieter Schmidt; Joern Kiselev; Moritz Höft; Fatima Yürek; Julian-Dominic Zimmermann; Elisa Weidner; Armin Hauß; Enrico Dähnert; Daniel Hadzidiakos; Natia Sichinava; Oscar Andrés Retana Romero; Laerson Hoff; Rudolf Mörgeli; Lennart Junge; Luzie Grüner; Antonia Eva Maria Harborth; Lisa Eymold; Tuba Gülmez; Elke Falk; Franziska Landgraf; Andreas Hölscher; Mani Rafii
Source
BMJ Open, Vol 13, Iss 3 (2023)
Subject
Language
English
ISSN
2044-6055
Abstract
Introduction Postoperative delirium (POD) is seen in approximately 15% of elderly patients and is related to poorer outcomes. In 2017, the Federal Joint Committee (Gemeinsamer Bundesausschuss) introduced a ‘quality contract’ (QC) as a new instrument to improve healthcare in Germany. One of the four areas for improvement of in-patient care is the ‘Prevention of POD in the care of elderly patients’ (QC-POD), as a means to reduce the risk of developing POD and its complications.The Institute for Quality Assurance and Transparency in Health Care identified gaps in the in-patient care of elderly patients related to the prevention, screening and treatment of POD, as required by consensus-based and evidence-based delirium guidelines. This paper introduces the QC-POD protocol, which aims to implement these guidelines into the clinical routine. There is an urgent need for well-structured, standardised and interdisciplinary pathways that enable the reliable screening and treatment of POD. Along with effective preventive measures, these concepts have a considerable potential to improve the care of elderly patients.Methods and analysis The QC-POD study is a non-randomised, pre–post, monocentric, prospective trial with an interventional concept following a baseline control period. The QC-POD trial was initiated on 1 April 2020 between Charité-Universitätsmedizin Berlin and the German health insurance company BARMER and will end on 30 June 2023. Inclusion criteria: patients 70 years of age or older that are scheduled for a surgical procedure requiring anaesthesia and insurance with the QC partner (BARMER). Exclusion criteria included patients with a language barrier, moribund patients and those unwilling or unable to provide informed consent. The QC-POD protocol provides perioperative intervention at least two times per day, with delirium screening and non-pharmacological preventive measures.Ethics and dissemination This protocol was approved by the ethics committee of the Charité-Universitätsmedizin, Berlin, Germany (EA1/054/20). The results will be published in a peer-reviewed scientific journal and presented at national and international conferences.Trial registration number NCT04355195.