Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2018

A phase II cluster randomised controlled trial of a multi-component non-pharmacological intervention to prevent delirium for in-patients with advanced cancer (The PRESERVE pilot study)   (#349)

Annmarie Hosie 1 , Jane Phillips 1 , Lawrence Lam 1 , Slavica Kochovska 1 , Meg Brassil 2 , Beverly Noble 1 , Susan Kurrle 3 , Anne Cumming 4 , Gideon Caplan 5 , Richard Chye 6 , Brian Le 7 , E Wesley Ely 8 , Peter Lawlor 9 , Shirley Bush 9 , Jan Maree Davis 10 , Melanie Lovell 11 , Linda Brown 1 , Belinda Fazekas 1 , Seong Leang Cheah 1 , Layla Edwards 1 , Meera Agar 1
  1. IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, UTS, Ultimo, NSW, Australia
  2. Flinders University, Adelaide, SA, Australia
  3. University of Sydney, Sydney, NSW, Australia
  4. Australian Commission on Safety and Quality in Health Care, Sydney, NSW, Australia
  5. Prince of Wales Hospital, Randwick, NSW, Australia
  6. Sacred Heart Palliative Care Service, St. Vincent's Hospital, Sydney, NSW, Australia
  7. Royal Melbourne Hospital, Melbourne, VIC, Australia
  8. School of Medicine, Vanderbilt University, Nashville, TN, USA
  9. University of Ottawa, Ottawa, ON, Canada
  10. Calvary Hospital, Kogarah, NSW, Australia
  11. HammondCare, Greenwich, NSW, Australia



  1. Determine if a multicomponent non-pharmacological delirium prevention intervention is feasible, acceptable and deliverable with high adherence and fidelity in people with advanced cancer in hospital; and
  2. Describe the strategies participating sites used to implement the delirium measurement tools and prevention intervention.


The study was a phase II cluster randomised controlled trial of a multi-component non-pharmacological delirium prevention intervention (‘intervention’). Four Australian palliative care units participated, with two randomised to the intervention arm and two to the waitlist control arm. The intervention consisted of care strategies to preserve natural sleep, maintain optimal vision and hearing, optimise hydration, promote communication, orientation and cognition, optimise mobility, and promote family partnership. All units implemented a structured delirium screening and diagnostic assessment process. After a two-month site training period, data were collected for 70 patients aged ≥18 years with a diagnosis of advanced cancer for the first seven days of admission. We obtained patient, family, staff and volunteer perspectives about feasibility and acceptability of the intervention using brief interviews and face-to-face surveys. Interdisciplinary teams at each unit tailored the delivery of the intervention to their available resources, and strategies to individual patient need. The primary outcome was adherence to the intervention. Secondary outcomes were fidelity to the protocol, feasibility, acceptability and sustainability of processes and measures, and delirium incidence and severity.


This poster presentation will report preliminary results of the trial, and describe how the palliative care teams implemented the delirium measures and prevention strategies in their respective units.


This study will provide feasibility, acceptability and preliminary efficacy data to inform a future phase III trial of the intervention. Results also will inform the implementation of processes to meet the Delirium Clinical Care Standard Indicators 1-3 in palliative care units from January 2019.