A Validation and Cost-Analysis Study of a Targeted School-Based Dental Check-Up Intervention: Children’s Dental Program

Background: Limited evidence exists to inform best practice approaches to implement school-based dental screening to address child retention via referral for dental services. This research tested the null hypothesis that a targeted school-based dental check-up program (intervention) has a 75% child retention rate for public dental care (H0 = 0.75). Methods: A prospective non-randomised controlled trial was conducted with a convenience sampling approach in metropolitan Melbourne, Australia. Children in the intervention group were recruited from two preschools and two primary schools from a low socioeconomic area. Children in the standard care group were recruited from the local public dental service. Statistical analysis was performed using Stata IC Version 12. Results: Children in the intervention (45%) were significantly less likely to have never had a dental check-up compared to standard care (20%) (p < 0.001). There was no significant difference for the child retention rate for the intervention group when compared against the null hypothesis (p = 0.954). The total society costs were AU$754.7 and AU$612.2 for the intervention and standard care groups, respectively (p = 0.049). Conclusions: This validation study provides evidence that a targeted school-based dental check-up program can achieve a 75% child retention rate and should be considered for program expansion.

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A comparison of hydrophobic polyurethane and polyurethane peripherally inserted central catheter: results from a feasibility randomized controlled trial

Trials ◽

10.1186/s13063-020-04699-z ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Nicole C. Gavin ◽

Tricia M. Kleidon ◽

Emily Larsen ◽

Catherine O’Brien ◽

Amanda Ullman ◽

...

Keyword(s):

Standard Care ◽

Dwell Time ◽

Controlled Trial ◽

Intervention Group ◽

Trial Registration ◽

Care Group ◽

Control Group ◽

Peripherally Inserted Central Catheter ◽

Central Catheter ◽

Efficacy Trial

Abstract Background To evaluate the feasibility of an efficacy trial comparing a hydrophobic polyurethane peripherally inserted central catheter (PICC) with a standard polyurethane PICC. Methods This pilot randomised controlled trial (RCT) was conducted between May 2017 and February 2018. Adult participants (n = 111) were assigned to hydrophobic polyurethane PICC with proximal valve (intervention) or a polyurethane PICC with external clamp (standard care). Primary outcome was trial feasibility including PICC failure. Secondary outcomes were central line-associated bloodstream infection, local infection, occlusion, thrombosis, fracture and dislodgement, phlebitis, local or systemic allergic reaction, and PICC dwell time. Results All feasibility outcomes were achieved, apart from eligibility criteria. In total, 338 patients were screened, 138 were eligible (41%), and of these 111 were randomised (80%). Patients received the allocated PICC in 106 (95%) insertions. No patients withdrew from the study and there was no missing data. PICC failure was 24% (13/55) in the intervention group and 22% (12/55) in the standard care group (p = 0.820). PICC failure per 1000 PICC days was 16.3 in the intervention group and 18.4 in the control group (p = 0.755). The average dwell time was 12 days in the intervention and 8 days in the control group. Conclusions This study demonstrates the feasibility of an efficacy trial of PICC materials in an adult population, once adjustments were made to include not only in-patients, but also patients being discharged to the Hospital in the Home service. Trial registration Australia and New Zealand Clinical Trials Registry ACTRN12616001578493. Prospectively registered on 16 November 2016. The trial protocol was published a priori (Kleidon et al., Vasc Access 3:15–21, 2017).

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Facebook as a Novel Tool for Continuous Professional Education on Dementia: Pilot Randomized Controlled Trial

Journal of Medical Internet Research ◽

10.2196/16772 ◽

2020 ◽

Vol 22 (6) ◽

pp. e16772 ◽

Cited By ~ 4

Author(s):

Windy SY Chan ◽

Angela YM Leung

Keyword(s):

Professional Education ◽

Retention Rate ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Multiple Choice Questions ◽

Participant Engagement ◽

Significant Difference ◽

The Mean ◽

And Control

Background Social network sites (SNSs) are widely exploited in health education and communication by the general public, including patients with various conditions. Nevertheless, there is an absence of evidence evaluating SNSs in connecting health professionals for professional purposes. Objective This pilot randomized controlled trial was designed to evaluate the feasibility of an intervention aiming to investigate the effects of a continuous professional education program utilizing Facebook to obtain knowledge on dementia and care for patients with dementia. Methods Eighty health professionals from Hong Kong were recruited for participation in the study and randomized at a 1:1 ratio by a block randomization method to the intervention group (n=40) and control group (n=40). The intervention was an 8-week educational program developed to deliver updated knowledge on dementia care from a multidisciplinary perspective, either by Facebook (intervention group) or by email (control group) from October 2018 to January 2019. The primary outcomes were the effects of the intervention, measured by differences in the means of changes in pre- and postintervention scores of knowledge assessments from the 25-item Dementia Knowledge Assessment Scale (DKAS) and formative evaluation of 20 multiple choice questions. Other outcome measurements included participant compliance, participant engagement in Facebook, satisfaction, and self-perceived uses of Facebook for continuing professional education programs. Results Significantly more intervention group participants (n=35) completed the study than the control group (n=25) (P<.001). The overall retention rate was 75% (60/80). The mean of changes in scores in the intervention group were significant in all assessments (P<.001). A significant difference in the mean of changes in scores between the two groups was identified in the DKAS subscale Communication and Behavior (95% CI 0.4-3.3, P=.02). There was no significant difference in the total DKAS scores, scores of other DKAS subscales, and multiple choice questions. Participant compliance was significantly higher in the intervention group than in the control group (P<.001). The mean numbers of participants accessing the learning materials were 31.5 (SD 3.9) and 17.6 (SD 5.2) in the intervention and control group, respectively. Polls attracted the highest level of participant engagement, followed by videos. Intervention group participants scored significantly higher in favoring the use of Facebook for the continuing education program (P=.03). Overall, participants were satisfied with the interventions (mean score 4 of a total of 5, SD 0.6). Conclusions The significantly higher retention rate, together with the high levels of participant compliance and engagement, demonstrate that Facebook is a promising tool for professional education. Education delivered through Facebook was significantly more effective at improving participants’ knowledge of how people with dementia communicate and behave. Participants demonstrated positive attitudes toward utilizing Facebook for professional learning. These findings provide evidence for the feasibility of using Facebook as an intervention delivery tool in a manner that can be rolled out into practical settings.

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Efficacy of Levamisole with Standard Care Treatment vs Standard Care in Clinical Presentations of Non-Hospitalized Patients with COVID-19: A Randomized Clinical Trial

10.21203/rs.3.rs-964097/v1 ◽

2021 ◽

Author(s):

Mohammad Hossein Asgardoon ◽

Hamid Emadi koochak ◽

Mohammad Hassan Kazemi-Galougahi ◽

Ali Zare Dehnavi ◽

Behzad Khodaei ◽

...

Keyword(s):

Clinical Benefit ◽

General Health ◽

Standard Care ◽

Intervention Group ◽

Health Condition ◽

Hospitalized Patients ◽

Care Group ◽

Control Group ◽

Significant Difference ◽

General Health Condition

Abstract Introduction: Levamisole (LVM) demonstrated clinical benefit in a trial in patients with mild to moderate coronavirus disease 2019 (COVID-19), but its effect in a larger sample size needs to be confirmed. Methods In this randomized open-label trial, we enrolled non-hospitalized patients with mild to moderate COVID-19 at nine health centers in Tehran province, Iran, in 2021. Patients were randomly assigned to receive a 10-day course of LVM with standard care (n = 185), or standard care (n = 180) in a 1:1 ratio. On days 1 to 10, LVM was administered orally at a dosage of 50 mg. The participants were called and followed on days 1, 3, 5, 7, 9, and 14. The outcomes were general health condition, hospitalization rate, sign and symptoms, and adverse events (AEs). Generalized Estimating Equations model was used for analysis. Results Among 507 randomized patients, 473 started the experiment and received LVM in addition to standard care or received only the standard care (median age, 40 [IQR, 32-50.75] years; 164 [44.9%] women; 9.4% had diabetes, 8.8% hypertension, 1.6% cardiovascular disease), and 346 (98%) completed the trial. Compared to control group, LVM decreased the general health condition of the patients (B=-0.635; CI= -0.041, -0.329; P= 0.000). Patients in the LVM with standard care group had significantly lower odds of developing fever (OR= 0.260; 95% CI= ‎0.11‎‎3‎-0.59‎‎9‎; P = .002), chills (OR= 0.223; 95% CI= ‎‎0.07‎‎6‎-‎0.64‎‎8‎; P = 0.006), fatigue (OR= 0.576; 95% CI= ‎0.34‎‎6‎-‎0.96‎‎0‎‎; P = ‎0.034), and myalgia (OR= 0.54‎‎4‎; 95% CI= ‎0.31‎‎7‎-‎0.93‎‎2‎‎; P =0.027). During the therapy, there was no significant difference in the parameters of dyspnea, cough, diarrhea, nausea, vomiting, sore throat, hyposmia, dysgeusia, and anorexia (P > 0.05). No significant difference was observed in the rate of hospitalization. Although the intervention group had greater AEs than the control group, yet, the difference was not statistically significant. Conclusions LVM has clinical benefit in improving health condition of patients with mild to moderate COVID-19. Further studies are needed to confirm our findings. Trial Registration: Iranian Registry of Clinical Trials: IRCT20201124049480N1; Registration date: 28/03/2021.

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Facebook as a Novel Tool for Continuous Professional Education on Dementia: Pilot Randomized Controlled Trial (Preprint)

10.2196/preprints.16772 ◽

2019 ◽

Author(s):

Windy SY Chan ◽

Angela YM Leung

Keyword(s):

Professional Education ◽

Retention Rate ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Multiple Choice Questions ◽

Participant Engagement ◽

Significant Difference ◽

The Mean ◽

And Control

BACKGROUND Social network sites (SNSs) are widely exploited in health education and communication by the general public, including patients with various conditions. Nevertheless, there is an absence of evidence evaluating SNSs in connecting health professionals for professional purposes. OBJECTIVE This pilot randomized controlled trial was designed to evaluate the feasibility of an intervention aiming to investigate the effects of a continuous professional education program utilizing Facebook to obtain knowledge on dementia and care for patients with dementia. METHODS Eighty health professionals from Hong Kong were recruited for participation in the study and randomized at a 1:1 ratio by a block randomization method to the intervention group (n=40) and control group (n=40). The intervention was an 8-week educational program developed to deliver updated knowledge on dementia care from a multidisciplinary perspective, either by Facebook (intervention group) or by email (control group) from October 2018 to January 2019. The primary outcomes were the effects of the intervention, measured by differences in the means of changes in pre- and postintervention scores of knowledge assessments from the 25-item Dementia Knowledge Assessment Scale (DKAS) and formative evaluation of 20 multiple choice questions. Other outcome measurements included participant compliance, participant engagement in Facebook, satisfaction, and self-perceived uses of Facebook for continuing professional education programs. RESULTS Significantly more intervention group participants (n=35) completed the study than the control group (n=25) (P<.001). The overall retention rate was 75% (60/80). The mean of changes in scores in the intervention group were significant in all assessments (P<.001). A significant difference in the mean of changes in scores between the two groups was identified in the DKAS subscale Communication and Behavior (95% CI 0.4-3.3, P=.02). There was no significant difference in the total DKAS scores, scores of other DKAS subscales, and multiple choice questions. Participant compliance was significantly higher in the intervention group than in the control group (P<.001). The mean numbers of participants accessing the learning materials were 31.5 (SD 3.9) and 17.6 (SD 5.2) in the intervention and control group, respectively. Polls attracted the highest level of participant engagement, followed by videos. Intervention group participants scored significantly higher in favoring the use of Facebook for the continuing education program (P=.03). Overall, participants were satisfied with the interventions (mean score 4 of a total of 5, SD 0.6). CONCLUSIONS The significantly higher retention rate, together with the high levels of participant compliance and engagement, demonstrate that Facebook is a promising tool for professional education. Education delivered through Facebook was significantly more effective at improving participants’ knowledge of how people with dementia communicate and behave. Participants demonstrated positive attitudes toward utilizing Facebook for professional learning. These findings provide evidence for the feasibility of using Facebook as an intervention delivery tool in a manner that can be rolled out into practical settings.

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A Randomized Controlled Trial of Hydroxychloroquine as Prophylaxis for COVID-19 among Health Care Providers

The Open Public Health Journal ◽

10.2174/1874944502114010600 ◽

2021 ◽

Vol 14 (1) ◽

pp. 600-604

Author(s):

Ramin Parvizrad ◽

Ghasem Mosayebi ◽

Nader Zarinfar ◽

Morteza Mousavi-Hasanzadeh ◽

Seyedeh Zahra Razavi ◽

...

Keyword(s):

Health Care Providers ◽

Controlled Trial ◽

White Blood Cells ◽

Intervention Group ◽

Healthcare Services ◽

Care Group ◽

Control Group ◽

Care Providers ◽

Level Of Evidence ◽

Significant Difference

Background: Although there is a growing consensus that hydroxychloroquine may not be effective in the treatment of COVID-19 patients, there is still little high-quality evidence about the prophylactic effects of this medication. In this study, we aimed to evaluate the efficiency of hydroxychloroquine in preventing COVID-19 infection among healthcare workers. Methods: In this clinical trial, 90 healthcare providers from two referral hospitals of COVID-19 were divided into the hydroxychloroquine group (400 mg/week for eight weeks) and the routine-care group. Serum CRP levels and the frequency of T-helper (CD4+ cells) and T-cytotoxic (CD8+ cells) were assessed at the beginning and end of the study. The groups were compared in terms of White Blood cells (WBCs), polymorph nuclear cells (PMNs), lymphocytes (LYM), hemoglobin (Hb), and platelets (Plt.). Results: The results revealed no significant differences between the two groups in terms of WBC, PMN, LYM, Hb, Plt., CD4, and CD8. The mean difference of the CD4:CD8 ratio showed a significantly higher decrease (P=0.05) in hydroxychloroquine group than in the control group (0.18 vs. 0.02). The incidence of COVID-19 was 15% (95%CI: 12-18%) in the control group and 10% (95%CI: 8-12%) in the intervention group; however, no significant difference was observed between the two groups in this regard (P=0.45). Conclusion: Our study findings boost an increasing level of evidence that hydroxychloroquine is not an effective prophylactic medication against COVID-19 and might even exacerbate the profile of pandemic containment efforts by adding more pain to patients’ life and healthcare services.

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An eHealth Program for Patients Undergoing a Total Hip Arthroplasty: Protocol for a Randomized Controlled Trial (Preprint)

10.2196/preprints.9654 ◽

2017 ◽

Author(s):

Rosemary Saunders ◽

Karla Seaman ◽

Catherine Ashford ◽

Trudy Sullivan ◽

Judith McDowall ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Patient Outcomes ◽

Hip Arthroplasty ◽

Standard Care ◽

Controlled Trial ◽

Intervention Group ◽

Primary Outcome Measure ◽

Secondary Outcome ◽

Care Group ◽

Total Hip

BACKGROUND Total hip arthroplasty is an effective surgical procedure commonly used worldwide for patients suffering the disabling effects of osteoarthritis when medical therapy is unsuccessful. Traditionally pre- and postoperative information for patients undergoing a hip arthroplasty has been provided by paper-based methods. Electronic health (eHealth) programs to support individualized patient education on preoperative preparation, in-patient care, and home rehabilitation have the potential to increase patient engagement, enhance patient recovery, and reduce potential postoperative complications. OBJECTIVE The aim of this study is to compare the addition of an eHealth program versus standard care for pre- and postoperative education on patient outcomes for primary total hip arthroplasty. METHODS One hundred patients undergoing a primary elective total hip arthroplasty will be recruited from a metropolitan hospital in Western Australia to participate in a 6-month parallel randomized control trial. Participants will be randomized to either the standard care group (n=50) and will be given the education booklet and enrolled to attend a 1-hour education session, or the intervention group (n=50), and will receive the same as the standard care plus access to an eHealth program titled “My Hip Journey.” The eHealth program encourages the patient to log in daily, from 2 weeks prior to surgery to 30 days postsurgery. The information on the platform will be aligned with the patient's individual surgical journey and will include exercises to be completed each day for the duration of the program. The primary outcome measure is the Hip Dysfunction and Osteoarthritis Outcome Score, version LK 2.0. Secondary outcome measures include the EuroQoL EQ-5D-5L, a 5-level 5-dimension quality of life measure, and the Self-Efficacy for Managing Chronic Disease Scale. Data will be collected at pre-admission (presurgery) and at 6 weeks, 3 months, and 6 months postsurgery. A patient satisfaction survey will be completed 6 weeks postsurgery and Web-based analytics will be collected 6 months postsurgery. A cost-effectiveness analysis, using the intention-to-treat principle, will be conducted from the hospital’s perspective. RESULTS Enrollment in the study commenced in January 2018 with recruitment due for completion towards the end of the year. The first results are expected to be submitted for publication in 2019. CONCLUSIONS The outcomes and cost of using an eHealth program to support a patient’s recovery from a hip arthroplasty will be compared with standard care in this study. If the eHealth program is found to be effective, further implementation across clinical practice could lead to improvement in patient outcomes and other surgical areas could be incorporated. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12617001433392; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373657&isReview=true (Archived by WebCite at http://www.webcitation.org/6yzoTuggx). REGISTERED REPORT IDENTIFIER RR1-10.2196/9654

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A School-Based Intervention to Reduce Excess Weight in Overweight and Obese Primary School Students

Biological Research For Nursing ◽

10.1177/1099800416654261 ◽

2016 ◽

Vol 18 (5) ◽

pp. 531-540 ◽

Cited By ~ 6

Author(s):

Maryam Amini ◽

Abolghassem Djazayery ◽

Reza Majdzadeh ◽

Mohammad-Hossein Taghdisi ◽

Haleh Sadrzadeh-Yeganeh ◽

...

Keyword(s):

Primary School ◽

Nutrition Education ◽

Primary Schools ◽

Comparison Group ◽

Controlled Trial ◽

Intervention Group ◽

Excess Weight ◽

World Health ◽

Moderate Activity ◽

Significant Difference

Background: This study evaluated the effect of an intervention for reducing excess weight gain in primary school-age children in Tehran. Methods: A cluster-randomized controlled trial was conducted in 12 primary schools in Tehran. Three hundred thirty-four pupils, 167 in the intervention and 167 in the comparison group, determined to be overweight or obese based on World Health Organization standards, were recruited for the study. The intervention included nutrition education and increased physical activity (PA) for the pupils, lifestyle modification for parents, and a change in food items sold at the schools’ canteens. The entire intervention lasted approximately 18 weeks. Measures were taken before and immediately after the intervention. Results: The intervention significantly reduced body mass index Z-score and hip circumference ( p = .003 and p < .001, respectively). Waist circumference increased in both groups, but the increase was higher in the comparison group ( p = .001). No significant difference was seen in time spent on TV viewing between groups ( p = .08). Vigorous PA increased in the intervention group ( p < .001), while the comparison group showed an increase in moderate activity only ( p < .001). Energy intake increased significantly in the intervention group ( p < .001). Neither triceps skinfold thickness nor time spent on the computer changed in the intervention group ( p = .51 and p = .1, respectively), while they increased in the comparison group ( p < .001 and p = .004, respectively). Conclusion: The study provides a successful model for the implementation of similar interventions throughout the country.

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Safety and efficacy of antenatal milk expressing for women with diabetes in pregnancy: protocol for a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2014-006571 ◽

2014 ◽

Vol 4 (10) ◽

pp. e006571 ◽

Cited By ~ 9

Author(s):

Della A Forster ◽

Susan Jacobs ◽

Lisa H Amir ◽

Peter Davis ◽

Susan P Walker ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Breast Milk ◽

Standard Care ◽

Controlled Trial ◽

Intervention Group ◽

Care Group ◽

Diabetes In Pregnancy ◽

Increased Risk ◽

Randomised Controlled ◽

In Pregnancy

IntroductionMany maternity providers recommend that women with diabetes in pregnancy express and store breast milk in late pregnancy so breast milk is available after birth, given (1) infants of these women are at increased risk of hypoglycaemia in the first 24 h of life; and (2) the delay in lactogenesis II compared with women without diabetes that increases their infant's risk of receiving infant formula. The Diabetes and Antenatal Milk Expressing (DAME) trial will establish whether advising women with diabetes in pregnancy (pre-existing or gestational) to express breast milk from 36 weeks gestation increases the proportion of infants who require admission to special or neonatal intensive care units (SCN/NICU) compared with infants of women receiving standard care. Secondary outcomes include birth gestation, breastfeeding outcomes and economic impact.Methods and analysisWomen will be recruited from 34 weeks gestation to a multicentre, two arm, unblinded randomised controlled trial. The intervention starts at 36 weeks. Randomisation will be stratified by site, parity and diabetes type. Women allocated to the intervention will be taught expressing and encouraged to hand express twice daily for 10 min and keep an expressing diary. The sample size of 658 (329 per group) will detect a 10% difference in proportion of babies admitted to SCN/NICU (85% power, α 0.05). Data are collected at recruitment (structured questionnaire), after birth (abstracted from medical record blinded to group), and 2 and 12 weeks postpartum (telephone interview). Data analysis: the intervention group will be compared with the standard care group by intention to treat analysis, and the primary outcome compared using χ2 and ORs.Ethics and disseminationResearch ethics approval will be obtained from participating sites. Results will be published in peer-reviewed journals and presented to clinicians, policymakers and study participants.Trial registration numberAustralian Controlled Trials Register ACTRN12611000217909.

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Effects of a muscular stretching and strengthening school-based exercise program on posture, trunk mobility, and musculoskeletal pain among elementary schoolchildren - a randomized controlled trial

Fisioterapia em Movimento ◽

10.1590/1980-5918.032.ao08 ◽

2019 ◽

Vol 32 ◽

Cited By ~ 1

Author(s):

Mariana Vieira Batistão ◽

Letícia Carnaz ◽

Roberta de Fátima Carreira Moreira ◽

Tatiana de Oliveira Sato

Keyword(s):

Musculoskeletal Pain ◽

Controlled Trial ◽

Statistical Significance ◽

Intervention Group ◽

Exercise Program ◽

Control Group ◽

School Based ◽

Postural Changes ◽

Significant Difference ◽

Strengthening Exercises

Abstract Introduction: The exercise benefits for the most prevalent postural changes require proper investigation, with large samples, control group, and concealed allocation. Objective: To assess the effects of a muscular stretching and strengthening school-based exercise program on posture, trunk mobility, and musculoskeletal pain among elementary schoolchildren. Method: Three hundred students from three schools in Brazil were evaluated. Stretching and strengthening exercises, twice a week, for eight weeks in group sessions were provided by one physiotherapist. The control group did not undergo any intervention. Head, back and shoulder posture were qualitatively evaluated. Head and trunk alignment were evaluated using the Posture Assessment Software. Cervical, thoracic, low back and upper limb pain were assessed for the last seven days. The trunk mobility was recorded through the flexibility of the posterior chain. Posture, pain and trunk mobility were recorded at baseline and after the intervention. Groups were compared using χ2 test, two-way MANOVA, and two-way ANOVA, with α set at 5%. Results: Shoulder posture showed significant results (P = 0.04), the intervention group showed the lower worsening rate. In the quantitative evaluation, a statistically significant difference was observed between assessments (P < 0.01 for head and trunk; ES = 0.53) but not between groups. The intervention group had a higher percentage of improvement in the overall musculoskeletal pain (P = 0.04; ES = 0.54). Mobility decreased an average of 1.8° in the control group and increased 5.0° in the intervention group, without statistical significance. Conclusion: The program was effective in reducing pain level and shoulder misalignment at the intervention group.

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Multicomponent Intervention to Prevent Delirium in Hospitalized Older Patients (DRAFT)

10.1093/med/9780190658618.003.0011 ◽

2018 ◽

Author(s):

Peter Lawlor

Keyword(s):

Risk Factors ◽

Comparative Effectiveness ◽

Older Patients ◽

Standard Care ◽

Medical Service ◽

Controlled Trial ◽

Intervention Group ◽

Baseline Risk ◽

Care Group ◽

Multicomponent Intervention

This chapter, reports on a prospectively matched controlled trial in which Inouye et al. examined the comparative effectiveness of a targeted multicomponent strategy for reducing the risk of delirium with that of usual standard care. The six targeted baseline risk factors in delirium-free patients admitted to a medical service in a teaching hospital were cognitive impairment, sleep deprivation, immobility, visual impairment, hearing impairment, and dehydration. Using standardized interventions for each of these when present, 42/426 (9.9%) of those in the intervention group had a first-incident episode of delirium compared to 64/426 (15%) in the usual care group, representing a statistically significant reduction of approximately 33% in first-incident episodes of delirium. The number of patient-days with delirium (105 vs. 161) and delirium episodes (62 vs. 90) were significantly lower in the intervention group. Primary prevention of delirium was effective.

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