#Post traumatic amnesia treatment registration#
#Post traumatic amnesia treatment trial#
#Post traumatic amnesia treatment series#

Pharmacological agents are frequently used, including anticonvulsants, antidepressants, beta-blockers, narcotics, benzodiazepines, neuroleptics and anti-parkinsonian medications (Duraski, 2011 Fleminger et al., 2006 Francisco et al., 2007 Fugate et al., 1997 Harmsen et al., 2004), however, evidence for their efficacy is weak (Bayley et al., 2019 Hicks et al., 2018 Janzen et al., 2014 McKay et al., 2021 Mehta et al., 2018 Nash et al., 2019 Williamson et al., 2019). Given the significant impact of agitated behaviours on patients, their families and healthcare staff, the effective management of agitation during the PTA period is critical.Įvidence in support of effective intervention for managing agitation during PTA is lacking (Janzen et al., 2014 McNett et al., 2012 Mortimer & Berg, 2017).

Agitation may cause distress for families, which can reduce their quality of life and ability to cope and provide adequate patient support (Norup et al., 2010). Behavioural changes and longer PTA duration have also been associated with increased burden on family members, which can negatively impact the relationship between patients and families (Brooks et al., 1987 Norup et al., 2010). Agitated behaviours increase the burden on staff and the risk of burnout such behaviours can be disruptive and can pose a significant safety risk, and agitated patients are at increased risk of falls and often wander, thus requiring frequent supervision (Becker, 2012 Brooke et al., 1992 Montgomery et al., 1997 Sandel & Mysiw, 1996). The disorientation and anterograde amnesia that is characteristic of PTA (Russell & Smith, 1961 Sherer et al., 2020 Stuss et al., 1999), is thought to impact patients’ ability to process and contextualise stimuli, resulting in inappropriate responses that manifest as agitation (Fugate et al., 1997 Harmsen et al., 2004 McKay et al., 2018 Noé et al., 2007).Īgitation is associated with poorer patient outcomes, including increased length of hospital stay, reduced engagement in rehabilitation, poorer cognitive and motor functioning and longer PTA duration (Bogner et al., 2001 Kadyan et al., 2004 Lequerica et al., 2007 Nott et al., 2006 Spiteri et al., 2021). A recent meta-analysis found that 44% of patients in PTA experience agitation, including restlessness, disinhibition, perseveration, impulsivity, emotional lability, confusion and verbal and physical aggression (Phyland et al., 2021).

#Post traumatic amnesia treatment registration#

Systematic review registration number: PROSPERO (CRD42020186802), registered May 2020.Īgitated behaviours are frequently observed during the early recovery period following traumatic brain injury (TBI), known as ‘post-traumatic amnesia’ (PTA) or ‘post-traumatic confusional state’ (PTCS) (Bogner et al., 2001 Kadyan et al., 2004 Nott et al., 2006). Further research is needed to evaluate non-pharmacological interventions for reducing agitation during PTA after TBI. Interventions involving music therapy had the highest level of evidence, although study quality was generally low to moderate. Key methodological concerns included absence of a control group, a lack of formalised agitation measurement and inconsistent concomitant use of pharmacology. Non-pharmacological interventions were music therapy, behavioural strategies and environmental modifications, physical restraints and electroconvulsive therapy.

#Post traumatic amnesia treatment series#

Twelve studies were included in the review: two randomized cross-over trials, three quasi-experimental studies, four cases series and three case reports.

Eligible studies were critically appraised for methodological quality using Joanna Briggs Institute Critical Appraisal Instruments and findings were reported in narrative form. Any non-pharmacological interventions for reducing agitation were considered, with any comparator accepted. Eligible studies included participants aged 16 years and older, showing agitated behaviours during PTA.

#Post traumatic amnesia treatment trial#

Key databases searched included MEDLINE Ovid SP interface, PubMed, CINAHL, Excerpta Medica Database, PsycINFO and CENTRAL, with additional online reviewing of key journals and clinical trial registries to identify published or unpublished studies up to May 2020. This systematic review aims to synthesize current evidence on the effectiveness of non-pharmacological interventions for agitation during PTA in adults with TBI. Non-pharmacological interventions are frequently used to manage agitation, yet their efficacy is largely unknown. Agitation is common in the early recovery period following traumatic brain injury (TBI), known as post-traumatic amnesia (PTA).