Early activation and sleep-promoting routines to reduce delirium after CABG
DREAMS-OT Trial: Delirium Reduction Through Early Activation in Motivating and Sleep Promoting Routines: A Randomized Controlled Trial of Occupational Therapy for ICU Patients After Coronary Artery Bypass Graft (CABG) Surgery
We will test whether early occupational therapy combined with sleep-promoting routines (DREAMS-OT) can reduce delirium in adults undergoing elective CABG surgery.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 300 (estimated) |
| Ages | 21 Years to 99 Years |
| Sex | All |
| Sponsor | National University Hospital, Singapore Academic / other |
| Locations | 1 site (Singapore) |
| Trial ID | NCT06107517 on ClinicalTrials.gov |
What this trial studies
This randomized controlled trial will compare the DREAMS-OT program—early, intensive occupational therapy plus structured sleep-promoting routines—to standard post-CABG care. Adults aged 21 and over scheduled for elective CABG at National University Hospital Singapore who can consent and speak English or Mandarin will be enrolled and randomized to intervention or control. The primary outcome is the incidence of postoperative delirium within five days after surgery, and the study will also evaluate the cost-effectiveness of the intervention. Patients with severe preexisting cognitive or sensory impairments, those who develop delirium before the intervention, or those with unstable surgical complications are excluded.
Who should consider this trial
Good fit: Ideal candidates are adults (≥21) scheduled for elective CABG at National University Hospital who can provide consent and communicate in English or Mandarin and do not have severe preexisting cognitive or hearing impairments.
Not a fit: Patients who develop delirium before treatment begins, those with progressive neurological disorders, severe cognitive or hearing impairment, or pregnant women are unlikely to benefit from this intervention.
Why it matters
Potential benefit: If successful, DREAMS-OT could lower the number of patients who develop delirium after CABG and may reduce ICU and hospital length of stay.
How similar studies have performed: Multicomponent programs including early mobilization and sleep protocols have reduced delirium in older surgical and ICU patients, but occupational-therapy–focused interventions specifically for post-CABG patients have been less extensively studied.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patients deemed medically suitable for elective CABG surgery * Patients aged 21 years and above * Patients who are English or Mandarin speaking. * Patients who are able to provide consent Exclusion Criteria: * Patients who speak other languages are excluded due to the language requirements of certain outcome measures. * Patients with premorbid severe hearing impairment, severe cognitive impairment, progressive neurological disorders and psychological disorders will be excluded. * Patients with surgical complications resulting in profuse bleeding from any invasive sites, septic shock unresponsive to maximal treatment, and those who are moribund or have an expected mortality within 48 hours will be excluded. * Pregnant women will also be excluded from the study as well. * Patients who develop delirium before initiation of the treatment are also excluded from the study.
Where this trial is running
Singapore
- National University Hospital — Singapore, Singapore (Recruiting)
Study contacts
- Principal investigator: Su Ren Wong — National University Hospital, Singapore
- Study coordinator: Megan HL Tan
- Email: megan_huei_lin_tan@nuhs.edu.sg
- Phone: +65-96280613
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.