Dr Sutha Yoganathan reviews the new iPhone app: Confusion: Delirium and Dementia
App type: A mix of E-learning/ Clinical Bedside.
Platform and Costs: Apple, Free
Target Audience: Junior Doctors, GPs, Allied health Professionals, Medical Students, Hospital Doctors
Test Drive: The delirium and dementia app is one of the few clinical apps that have been designed with the UK-NHS inspired approach towards managing the confused patient. Based upon the latest NICE guidelines of their respective subject matter, the app makes a decent stab at tackling what many junior doctors find to be a tricky issue. It incorporates the short-CAM tool and takes the doctor through a structured approach towards assessing the confused patient and in-particular distinguishing between delirium and dementia.
Some sections of the app can be quite clunky to use, for instance due to copyright issues, there are no tools to formally assess memory such as the MMSE although there is the abbreviated AMTS and a link to the MOCA [Montreal Cognitive assessment tool] that bizarrely has to be printed off from your phone. The mental capacity act and its brood of MCA and DOLLs are glaring absentees. However, other bits prove invaluable such as the short guide to sedative drugs and their dosing. The delirium section contains a useful mnemonic to identify causes and a handy ‘what to do next’ section.
Validity: The App is based upon NICE guidelines and probably has face validity. It is yet to be trialled formally in the clinical setting.
Accreditation: No formal accreditation yet
Summary Overview: The delirium and dementia app is the first app of its kind to try and tackle a potentially tricky scenario. It is the opinion of this reviewer that it would be an invaluable aid towards junior doctors embarking on their night shift or ward cover weekend where they are likely to come face to face with an old patient swinging his/her stick.