{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T12:41:04Z","timestamp":1793191264633,"version":"4.5.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T00:00:00Z","timestamp":1653091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100001700","name":"MEXT","doi-asserted-by":"publisher","award":["17K19875"],"award-info":[{"award-number":["17K19875"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The objective of this survey was to identify areas where doctors have divergent practices in pharmacological treatment for hyperactive delirium in terminally ill patients with cancer.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a survey of Japanese palliative care physicians and liaison psychiatrists. Inquiries were made regarding: (i) choice of drug class in the first-line treatment, (ii) administration methods of the first-line antipsychotic treatment, (iii) starting dose of antipsychotics in the first line treatment and maximum dose of antipsychotics in refractory delirium, and (iv) choice of treatment when the first-line haloperidol treatment failed. Respondents used a five-point Likert scale.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Regarding choice of drug class in the first-line treatment, more doctors reported that they \u2018frequently\u2019 or \u2018very frequently\u2019 use antipsychotics only than antipsychotics and benzodiazepine (oral: 73.4 vs. 12.2%; injection: 61.3 vs. 11.6%, respectively). Regarding administration methods of the first-line antipsychotic treatment, the percentage of doctors who reported that they used antipsychotics as needed and around the clock were 55.4 and 68.8% (oral), 49.2 and 45.4% (injection), respectively. There were different opinions on the maximum dose of antipsychotics in refractory delirium. Regarding the choice of treatment when the first-line haloperidol treatment failed, the percentage of doctors who reported that they increased the dose of haloperidol, used haloperidol and benzodiazepines, and switched to chlorpromazine were 47.0, 32.1 and 16.4%, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Doctors have divergent practices in administration methods of the first-line antipsychotic treatment, maximum dose of antipsychotics, and choice of treatment when the first-line haloperidol treatment failed. Further studies are needed to determine the optimal treatment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jjco\/hyac081","type":"journal-article","created":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T12:54:03Z","timestamp":1650977643000},"page":"905-910","source":"Crossref","is-referenced-by-count":3,"title":["Current practice of pharmacological treatment for hyperactive delirium in terminally ill cancer patients: results of a nationwide survey of Japanese palliative care physicians and liaison psychiatrists"],"prefix":"10.1093","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5092-9377","authenticated-orcid":false,"given":"Yoshinobu","family":"Matsuda","sequence":"first","affiliation":[{"name":"Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center , Sakai , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital , Hamamatsu , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyofumi","family":"Oya","sequence":"additional","affiliation":[{"name":"Peace Home Care Clinic , Otsu , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8081-5979","authenticated-orcid":false,"given":"Keita","family":"Tagami","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Tohoku University School of Medicine , Sendai , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akemi Shirado","family":"Naito","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Miyazaki Medical Association Hospital , Miyazaki , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideyuki","family":"Kashiwagi","sequence":"additional","affiliation":[{"name":"Department of Transitional and Palliative Care, Aso Iizuka Hospital , Iizuka , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Otani","sequence":"additional","affiliation":[{"name":"Department of Palliative and Supportive Care, Palliative Care Team, National Kyushu Cancer Center , Fukuoka , Japan"},{"name":"Department of Palliative and Supportive Care, Palliative Care Team , St. Mary\u2019s Hospital, Kurume , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,5,21]]},"reference":[{"key":"2022093018321873300_ref1","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and Statistical Manual of Mental Disorders, DSM-5","author":"Association AP","year":"2013","edition":"5th"},{"key":"2022093018321873300_ref2","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1093\/jjco\/hyv100","article-title":"Prevalence, course and factors associated with delirium in elderly patients with advanced cancer: a longitudinal observational study","volume":"45","author":"Uchida","year":"2015","journal-title":"Jpn J Clin Oncol"},{"key":"2022093018321873300_ref3","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1001\/archinte.160.6.786","article-title":"Occurrence, causes, and outcome of delirium in patients with advanced cancer: a prospective study","volume":"160","author":"Lawlor","year":"2000","journal-title":"Arch Intern Med"},{"key":"2022093018321873300_ref4","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1176\/appi.psy.43.3.183","article-title":"The delirium experience: delirium recall and delirium-related distress in hospitalized patients with cancer, their spouses\/caregivers, and their nurses","volume":"43","author":"Breitbart","year":"2002","journal-title":"Psychosomatics"},{"key":"2022093018321873300_ref5","doi-asserted-by":"crossref","first-page":"2004","DOI":"10.1002\/cncr.24215","article-title":"Impact of delirium and recall on the level of distress in patients with advanced cancer and their family caregivers","volume":"115","author":"Bruera","year":"2009","journal-title":"Cancer"},{"key":"2022093018321873300_ref6","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1001\/jamainternmed.2016.7491","article-title":"Efficacy of oral risperidone, haloperidol, or placebo for symptoms of delirium among patients in palliative care: a randomized clinical trial","volume":"177","author":"Agar","year":"2017","journal-title":"JAMA Intern Med"},{"key":"2022093018321873300_ref7","doi-asserted-by":"crossref","first-page":"485","DOI":"10.7326\/M19-1860","article-title":"Antipsychotics for treating delirium in hospitalized adults: a systematic review","volume":"171","author":"Nikooie","year":"2019","journal-title":"Ann Intern Med"},{"key":"2022093018321873300_ref8","doi-asserted-by":"crossref","first-page":"295","DOI":"10.7326\/L19-0702","article-title":"Do neuroleptics still have a role in patients with delirium?","volume":"172","author":"Grouls","year":"2020","journal-title":"Ann Intern Med"},{"key":"2022093018321873300_ref9","first-page":"CD004770","article-title":"Drug therapy for delirium in terminally ill adults","volume":"1","author":"Finucane","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"2022093018321873300_ref10","doi-asserted-by":"crossref","first-page":"e574","DOI":"10.1634\/theoncologist.2018-0242","article-title":"Current pharmacotherapy does not improve severity of hypoactive delirium in patients with advanced cancer: pharmacological audit study of safety and efficacy in real world (phase-R)","volume":"24","author":"Okuyama","year":"2019","journal-title":"Oncologist"},{"key":"2022093018321873300_ref11","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1164\/rccm.2107138","article-title":"The Richmond agitation-sedation scale: validity and reliability in adult intensive care unit patients","volume":"166","author":"Sessler","year":"2002","journal-title":"Am J Respir Crit Care Med"},{"key":"2022093018321873300_ref12","doi-asserted-by":"crossref","first-page":"iv143","DOI":"10.1093\/annonc\/mdy147","article-title":"Delirium in adult cancer patients: ESMO clinical practice guidelines","volume":"29","author":"Bush","year":"2018","journal-title":"Ann Oncol"},{"key":"2022093018321873300_ref13","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/SPC.0b013e3283612241","article-title":"Palliative care in Japan: a review focusing on care delivery system","volume":"7","author":"Morita","year":"2013","journal-title":"Curr Opin Support Palliat Care"},{"key":"2022093018321873300_ref14","volume-title":"Delirium in Cancer Patients: JPOS-JASCC Clinical Practice Guidelines","year":"2019"},{"key":"2022093018321873300_ref15","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1016\/S1470-2045(20)30307-7","article-title":"Neuroleptic strategies for terminal agitation in patients with cancer and delirium at an acute palliative care unit: a single-centre, double-blind, parallel-group, randomised trial","volume":"21","author":"Hui","year":"2020","journal-title":"Lancet Oncol"},{"key":"2022093018321873300_ref16","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1001\/jama.2017.11468","article-title":"Effect of lorazepam with haloperidol vs haloperidol alone on agitated delirium in patients with advanced cancer receiving palliative care: a randomized clinical trial","volume":"318","author":"Hui","year":"2017","journal-title":"JAMA"},{"key":"2022093018321873300_ref17","volume-title":"Haloperidol and Lorazepam in Controlling Symptoms of Persistent Agitated Delirium in Patients with Advanced Cancer Undergoing Palliative Care"},{"key":"2022093018321873300_ref18","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1017\/S1041610215002446","article-title":"Expert opinions on the first-line pharmacological treatment for delirium in Japan: a conjoint analysis","volume":"28","author":"Okumura","year":"2016","journal-title":"Int Psychogeriatr"}],"container-title":["Japanese Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jjco\/article-pdf\/52\/8\/905\/46215070\/hyac081.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jjco\/article-pdf\/52\/8\/905\/46215070\/hyac081.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T19:49:26Z","timestamp":1664567366000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jjco\/article\/52\/8\/905\/6590154"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,21]]},"references-count":18,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,5,21]]},"published-print":{"date-parts":[[2022,8,5]]}},"URL":"https:\/\/doi.org\/10.1093\/jjco\/hyac081","relation":{},"ISSN":["1465-3621"],"issn-type":[{"value":"1465-3621","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,8]]},"published":{"date-parts":[[2022,5,21]]}}}