Congratulations to Professor Robert Sanders and co-investigators on securing an $800,000 Medical Research Future Fund (MRFF) Clinical Trials Activity Grant to advance research into post-operative delirium prevention in older adults.
Delirium is a highly distressing condition affecting up to 50 per cent of hospitalised older patients, and is associated with increased mortality, complications, longer hospital stays, and higher healthcare costs. Effective treatments are limited. This funding will address this critical gap through the NOTBADD Pilot Trial (NSAID administration Or Theatre Benzodiazepine Avoidance for Delirium and Days Alive and at Home).
The study is a pilot, double-blinded, multicentre randomised controlled trial designed to test the feasibility of pragmatic delirium-prevention strategies targeting routinely used perioperative therapies:
- NSAID (celecoxib) administration,
- Avoidance of peri-induction midazolam,
- Differing depths of anaesthesia guided by processed electroencephalography (EEG).
The pilot trial will enrol 120 patients aged 60 years or over undergoing major non-cardiac, non-intracranial surgery, with outcomes focusing on feasibility, post-operative delirium incidence, days alive and at home, pain, recovery quality, and safety. Findings from this pilot will inform a subsequent large-scale platform trial powered to detect meaningful reductions in delirium.
The study proposal was presented at the 2025 CTN Strategic Research Workshop by co-investigator Dr Benjamin Moran (featured in the banner image), where the investigator team received valuable peer feedback from delegates on the study design including support for transitioning into a perioperative platform trial.
The investigator team brings together experienced senior and emerging researchers from the ANZCA Clinical Trials Network, supported by statisticians with a strong track record in delivering large multicentre trials. Consumer partners played a central role in shaping the trial design, ensuring relevance, safety, and acceptability for older patients.
The trial is supported by the University of Sydney and builds on the team’s previous $4 million NHMRC-funded success, the DECIDE trial (Dexmedetomidine in Cardiac Surgical Intraoperative Drug Evaluation), a triple-blind, placebo-controlled randomised trial investigating whether intraoperative dexmedetomidine can reduce delirium, lower hospital costs, and preserve long-term cognitive outcomes in high-risk cardiac surgery patients.
