Diagnóstico, intervenção precoce e prevenção do Delirium no adulto: o que fazer na Atenção Primária À Saúde?

Luciana Almeida; Sónia  Martins; Nivaldo  Marins; Lia  Fernandes

doi:10.5712/rbmfc16(43)2366

Authors

Luciana Almeida Unidade de Saúde Familiar de Canelas - ACeS Gaia-Espinho https://orcid.org/0000-0002-1221-9953
Sónia Martins Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS) e Departamento de Neurociências Clínicas e Saúde Mental, Faculdade de Medicina da Universidade do Porto (FMUP) , Portugal https://orcid.org/0000-0002-1812-8913
Nivaldo Marins Centro Hospitalar Conde de Ferreira (CHCF), Porto, Portugal https://orcid.org/0000-0002-8013-3094
Lia Fernandes Departamento de Neurociências Clínicas e Saúde Mental e Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS), Faculdade de Medicina da Universidade do Porto (FMUP) Serviço de Psiquiatria, Centro Hospitalar Universitário São João (CHUSJ), Porto, Portugal https://orcid.org/0000-0002-3391-0647

DOI:

https://doi.org/10.5712/rbmfc16(43)2366

Keywords:

Delirium, Diagnostic Test Approval, Risk Factors, primary health care, Quaternary Prevention.

Abstract

Introduction: Delirium is a common syndrome, with considerable associated morbimortality, potentially preventable if the adequate prevention and screening measures are instituted. However, this condition is still little-known, mainly in Primary Health Care, and many times underdiagnosed. The aim of this work was to carry out a review about delirium as well as propose a diagnostic and therapeutic approach for Primary Health Care. Methods: A search of articles published between January 2008 and December 2020 in PubMed and Scielo with the mesh terms “delirium” combined with “primary health care” or “general practice” was performed. Results: The approach aims first to identify risk individuals using a multifactorial model composed of predisposing and precipitating factors. Regarding screening tests, the most widely used is the Confusion Assessment Method, but others like attention tests or the Richmond Agitation and Sedation Scale can be used as well, all in association with a thorough physical examination for diagnostic confirmation. The therapeutic and preventive approaches are mainly about the use of non-pharmacological methods to correct the risk factors. Final Considerations: Generally, the development of systematic training and screening programs involving a multidisciplinary team, including Primary Health Care members and the caregivers can be the key to success in reducing the incidence of delirium and its complications.

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