Delirium at the end of life – The 2013 EAPC Early Researcher Award


Associate Professor Meera Agar, Director of Palliative Care Braeside Hospital, Sydney, Australia. Meera talks about her award-winning research project, which she presented at the 13th World Congress of the EAPC, and how it feels to be a winner.

Assistant Professor Meera Agar (right) receiving her award from Professor Sheila Payne and Dr Franco De Conno

Assistant Professor Meera Agar (right) receiving her award from Professor Sheila Payne and Dr Franco De Conno

In February 2013, I was notified that I had been awarded the Early Researcher Award from the European Association for Palliative Care, at about the same time as I completed my doctoral thesis and submitted it into the ‘ether’ for examination. My PhD supervisor, Professor David Currow, had nominated me for this award some months earlier, as one’s supervisors tend to do!  My initial reaction was ‘why would they award this to me?’ However, I was honoured to be representing Australian palliative care research and a topic dear to my heart – delirium. I tried to utilise denial strategies for as long as possible when thinking about the minor sticking point of presenting a plenary to so many esteemed researchers – whose work I have read, and re-read informing both my research and clinical practice. That being said, to crystallise a programme of work into a 30-minute presentation has been really important in helping to clarify where we want to take this work in the future.

The award recognises a programme of work, which contributed to my PhD, exploring translating delirium evidence into practice, delirium pathophysiology, and a clinical trial programme evaluating the net clinical benefit of delirium therapeutics. This programme has involved collaboration with experienced qualitative, basic science and clinical trial methodologies, and critical partnerships from outside palliative care. We found that some variability seen in nursing and medical clinical practice relates to an evidence practice gap with implications for translation of the delirium evidence base into practice; equally, there are some aspects of delirium care unique to the palliative population. Anticholinergic prescribing in palliative care has potential impacts on function, symptoms and quality of life; however, it does not seem to be related to delirium occurrence. We have developed strong clinical trial methodology that addresses person responsible consent, outcome assessment, and key feasibility issues that can be widely applied to assessing the net clinical benefit of strategies to prevent and manage delirium in the palliative care population. This trial design has been truly tried and tested as we have recruited more than 90% of participants (n=217), with a further 14 participants needed to complete a randomised control trial comparing oral risperidone, oral haloperidol and placebo in the management of delirium in palliative care.

This award has affirmed not only my career choice to remain a clinician researcher, but also that research is a team effort and takes time, substantive investment of energy and many pitfalls on the way. I hope this award will contribute to future collaborations with researchers internationally with an interest in delirium and research outputs, which will provide evidence-based therapeutics both to prevent and manage delirium more effectively. In particular, I hope it will lead to a much-needed international clinical trial programme in delirium in palliative care populations.

And finally some advice for other early career researchers:

  • Don’t say no to opportunities even if they frighten you – supervisors will throw you in the deep end, but they also know how to pick up the pieces if necessary (but the worst of your fears will rarely happen);
  • Present and publish your work – critical comment from your peers can be one of your best friends;
  • Find opportunity to link with researchers outside the field of palliative care.
  • Listen to your patients – they know what is important and will keep your passion for research alive in those darker moments.

This article will also be published in the September issue of the European Journal of Palliative Care  and is reproduced here with kind permission.

Find out more …
The Early Researcher Award (formerly Young Investigator Award) was created as an annual award by the EAPC in 2009. This award is designed to recognise the work of young (novice) scientists and clinicians in the field of palliative care who have recently made, or are currently making, an outstanding contribution to research. It aims to highlight their personal career development and their potential for the future. Click here  to read posts from former Early Researcher Award prizewinners.

Coming up…
Joint runners up, Dr Barbara Gomes and Dr Jeroen Hasselaar, will also be talking about their research on the blog during the next two weeks.

Look out for announcements about the 2014 Early Researcher Award in the autumn. We’ll keep you posted via the EAPC website, Facebook and Twitter @EAPCOnlus. And we’ll also let you know when PowerPoint presentations from the 13th EAPC World Congress will be available to view online.

This entry was posted in EAPC Researcher Awards, EAPC World Congresses, European Journal of Palliative Care, RESEARCH and tagged . Bookmark the permalink.

3 Responses to Delirium at the end of life – The 2013 EAPC Early Researcher Award

  1. Dear Professor Meera Agar,
    I take the liberty of writing You my Congratulations about the success of Your Research. A urgent and delicate Research. I am a Linguist and I have been studying PreverbalPediatricPain, in nonPharmacologicalCare, since 2010, when my Little Nephew Giampaolo died at 19 months. I am his aunt. He was diagnosticated the AcuteLymphoblasticLeukemia at 12 months. He suffered Delirium. And his Delirium was underrecognized, underestimated and understudied. Last August 2012, I wrote the PreverbalPediatricEmergenceDeliriumScale, the PPED Scale. Recently, I wrote my best practice about this Scale. And, You will find the article on my website,, in the section of OncologicPsychoLinguistics. Dear Professor, imagine what my Little Giampaolo lived during his last month of life. Imagine. Imagine. Nobody could understand Him because he was a PreverbalChild, and I was never permitted to help Him, because I am not a HealthCareProfessional. I want to be-and-do all my best to HIs Memory for all the OncologicPreverbalChildren in the World. Luisella Magnani

  2. Pingback: Delirium at the end of life – The 2013 EAPC Early Researcher Award | EAPC Blog | All Things Palliative - Article Feed

  3. Pingback: Methodological Issues and Strategies in Clinical Research | HEALTHCARE

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