Quality, Content and Readability of NHS Delirium Information Resources: A Cross Sectional Study

Quality, Content and Readability of NHS Delirium Information Resources: A Cross Sectional Study

Introduction

Delirium is a common and distressing clinical syndrome with significant consequences for patients and families. Clear written information can help people understand the condition, recognise its symptoms, and know what support is available. This study assessed the quality, content, and readability of publicly available NHS delirium resources in England.

Methods

A cross sectional review was conducted using structured web searches in August 2026. English language resources produced by NHS organisations for patients or carers were included. The Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P) assessed understandability and actionability, meaning whether readers could identify what to do. A nine item delirium content checklist and a study specific four item metadata checklist were also applied. Text was analysed using Flesch Reading Ease and Flesch-Kincaid Grade Level.

Results

20 of 29 identified records were included. Mean understandability was 84.4%, with 19 resources scoring at least 70%. Mean actionability was 74.2%, with scores ranging from 20% to 100%. The mean content score was 7.55 out of 9, with four resources covering all nine items. All discussed causes and management, but only seven distinguished delirium from dementia and 11 reported prevalence. The mean metadata score was 3.2 out of 4. Mean Flesch Reading Ease was 54.7 and mean Flesch-Kincaid Grade Level was 8.8. Using commonly applied readability benchmarks, eight resources achieved a Reading Ease score of at least 60 and eight had a grade level of 8 or below.

Conclusions

NHS delirium resources generally covered the important information and achieved high understandability scores, although actionability varied. Readability remained challenging, with fewer than half meeting either benchmark. Future resources should use accessible language, provide clear advice, and explain the difference between delirium and dementia.