Effects of Non‐Pharmacological Interventions in Hospitals on Behaviours of Concern and Patient Experience: A Systematic Review

OBJECTIVES: To identify non-pharmacological interventions utilised in acute hospital settings to manage Behaviours of Concern (BoC) and investigate whether they changed the intensity and frequency of BoC. A secondary aim was to investigate the patient experience and satisfaction with non-pharmacological interventions. METHODS: Systematic searches were conducted in EMBASE, EMCARE, MEDLINE, PsychINFO and CINAHL, and PRISMA guidelines were followed. Reviewers screened titles and abstracts for eligibility, extracted data and appraised quality. Study quality was assessed with the Downs and Black Checklist. Due to heterogeneity, studies were synthesised using a narrative approach. RESULTS: Following database searches, 6261 manuscripts were identified, of which three met the inclusion criteria. Study quality was poor to fair. Behaviours of Concern were not measured in one study, another study found no significant difference between behaviours pre- and post- intervention, and the final study reported a lower occurrence of behaviours post-intervention. Implemented non-pharmacological interventions varied across the studies; one study only measured the effect of post traumatic amnesia assessment, one study identified mobilisation as the most frequently implemented intervention, and another study identified cognitive/intellectual interventions as the most frequently implemented intervention. None of the studies assessed patient experience or satisfaction with initiatives to manage BoC. CONCLUSIONS: There is a lack of high-quality evidence to determine the effects of non-pharmacological interventions to manage BoC in the acute hospital setting. Future research is needed to identify the non-pharmacological interventions utilised and the effects of these interventions, including on patient experience and satisfaction. TRIAL REGISTRATION: PROSPERO number: CRD42023381570.