Non-pharmacological interventions for managing acute pain and delirium in hospitalized older patients: a systematic review.

BACKGROUND: Delirium and acute pain are common and serious problems in hospitalized older patients, often leading to adverse outcomes such as prolonged hospital stays, cognitive decline, and higher mortality rates. While pharmacological treatments can have significant side effects in older adults, non-pharmacological interventions offer safer alternatives. OBJECTIVE: This systematic review aimed to evaluate the effectiveness of non-pharmacological interventions in managing acute pain and delirium in hospitalized older patients. METHODS: A comprehensive search was conducted across PubMed, Scopus, Web of Science, Embase, Cochrane Library, and Google Scholar databases up to July 2025. The review included randomized controlled trials and quasi-experimental studies involving patients aged ≥ 65 years that used non-pharmacological interventions. RESULTS: The review included eight studies. Music therapy and hand massage consistently reduced acute pain and anxiety among older patients, while the results for delirium prevention were mixed. some interventions, like geriatric care bundles, significantly reduced delirium incidence, while others showed no effect. These findings highlight the clinical relevance of non-pharmacological interventions as safer alternatives to pharmacological management in geriatric care. CONCLUSION: Non-pharmacological interventions are effective in reducing acute pain and anxiety among older inpatients, with some showing promise in delirium prevention. However, the variability in intervention types and study quality highlights the need for standardized protocols and further research.