PROfylactic Haloperidol in Patients Defined as High Risk for DElirium With Delirium Risk mOdel
- Registration Number
- NCT03199950
- Lead Sponsor
- Zuyderland Medisch Centrum
- Brief Summary
The hospital pharmacy at the Zuyderland Medical Centre developed the DElirium MOdel (DEMO) to predict which patients are at risk of developing a delirium in patients aged 60 or older. With this delirium risk prediction model we aim to predict more accurately which patients are at high risk of developing a delirium and want to investigate if these patients can benefit from prophylactic haloperidol.
- Detailed Description
Intro: Delirium is a common postoperative complication within geriatric patients. It is described delirium as a very stressful experience for the patient which can lead to prolonged hospital stay, higher cost, additional morbidity and increased mortality.
In 2013 the hospital pharmacy at the Zuyderland Medical Center developed the delirium risk prediction model to determine the chance of development of a delirium in patients aged 60 or older. Electronically available data such as age, polypharmacy, use of anti-dementia drugs, anti-depressants, anti-parkinsonian drugs, anti-diabetics, analgesics and/or sleeping medication were used in the study. The delirium risk prediction model was validated prospectively after retrospective development. The model will be used in this study to predict the risk of developing delirium postoperatively.
We expect prophylactic haloperidol to be effective in patients with a high risk of developing a delirium according to the delirium risk prediction model.
Aim: The PRODEO-study aims to reduce the incidence of postoperative delirium by administering prophylactic haloperidol to patients with a high risk of developing delirium according to the delirium risk prediction model.
Methods: The study is a randomized and double blind single center study with two parallel groups. Subjects ≥60 years with increased risk of postoperative delirium according to the delirium risk prediction model undergoing elective chirurgical or elective orthopedic surgery are eligible. Subjects will be excluded if they already use anti-psychotic drugs, are not able to take oral medication or when there are contra-indications. Haloperidol (1mg) or placebo will be administered at set times postoperatively. Subjects receive haloperidol 2dd1mg or a placebo 2dd during a maximum of five days during admission. On day 3 blood samples will be obtained in order to determine the true concentration levels of haloperidol. The primary endpoint is delirium incidence within 5 days after surgery. Secondary endpoints are costs of treatment, number of admission days, adverse events, true concentration levels of haloperidol and duration and severity of delirium.
Results: The study will start in June 2017 with an inclusion rate of 20 patients per week. An incidence reduction of 30% in the intervention group is expected. To reach sufficient statistical power a study population of 1366 subjects is needed. Duration of the inclusion period is expected to be 18 months.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 1366
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Prophylactic Haloperidol arm Haloperidol Patients will receive oral haloperidol 2dd1mg (08.00am \& 10.00pm) No treatment Placebo Oral Tablet Patients will receive oral placebo 2dd (08.00am \& 10.00pm)
- Primary Outcome Measures
Name Time Method Occurence of delirium Delirium within 5 days postoperative Will prophylactic haloperidol in high risk patients as established with DEMO reduce the incidence of delirium?
- Secondary Outcome Measures
Name Time Method Adverse events of intervention medication an average of two weeks Adverse events during admission in the hospital
Circulating concentration of Haloperidol up to 2 years Blood sample collection at day, trough concentration haloperidol in blood sample
Severity of delirium an average of two weeks DOS scores during admission
Costs of treatment up to 2 years Total costs of hospital stay
Days admitted to hospital an average of two weeks Total amount of days admitted to the hospital
Duration of delirium an average of two weeks Days DOS (Delirium observation scale) positive after surgery,
Trial Locations
- Locations (1)
Zuyderland Medisch Centrum
🇳🇱Sittard, Limburg, Netherlands