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Age and Ageing Advance Access published online on July 10, 2009
Age and Ageing, doi:10.1093/ageing/afp099
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© The Author 2009. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Understanding barriers to delirium care: a multicentre survey of knowledge and attitudes amongst UK junior doctors

Daniel Davis1 and Alasdair MacLullich2

1 Department of Clinical Geratology, University of Oxford, Headley Way, Oxford OX2 9DU, UK
2 Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK

Address correspondence to: D. Davis. Tel: (+44) 1865 221325; Fax: (+44) 1865 222901. Email: daniel.davis{at}magd.ox.ac.uk

Background: delirium is under-diagnosed and under-treated in comparison to other common and serious acute disorders. The reasons for this are unclear.

Objective: we conducted a multicentre survey of knowledge of and attitudes to delirium in trainee general physicians.

Design: questionnaire-based survey in 34 acute hospitals in the UK.

Methods: we developed a questionnaire designed to test knowledge of delirium prevalence, DSM-IV diagnostic criteria, use of specific screening tools, association with adverse outcomes, and pharmacological management. Questionnaires were completed and returned by hand to the researchers immediately after recruitment. Participants were a convenience sample of trainee doctors in general and emergency medicine.

Results: 784 trainee physicians participated. Most participants expressed the view that delirium has a high prevalence and that it is associated with serious adverse outcomes. However, they had poor knowledge of its diagnosis and treatment, reporting the need for better training. Experience working in geriatric medicine had only a modest effect on the ability to diagnose delirium.

Conclusions: UK training doctors' lack of basic knowledge of the diagnosis and management of delirium, rather than a lack of awareness of its high prevalence and clinical significance, appears to be important in determining its under-recognition.

Keywords: delirium, questionnaire, survey, elderly

Received 25 June 2008; accepted in revised form 12 April 2009.


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