Document Detail


Limited evidence for the effectiveness of p.r.n. Medications among psychiatric inpatients.
MedLine Citation:
PMID:  19461392     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The use of medications on a p.r.n. basis on psychiatric inpatient wards is common and widespread but without clear evidence of effectiveness. While individual studies have explored the use of p.r.n. medications in patients receiving scheduled psychotropic medications, no systematic review of the effectiveness of this use of p.r.n. medications has been done. A MEDLINE search was performed of all articles published in English between 1966 and November 2008. Studies were included only if they involved psychiatric patients and if they quantitatively explored the effectiveness of p.r.n. medications. Ten retrospective studies were identified that met inclusion criteria. Among the studies involving adult inpatients, estimates of effectiveness, primarily in the management of agitation, were consistently moderately high, averaging approximately 75%. These studies mainly involved use of antipsychotics and benzodiazepines. Lower estimates of about 30% were obtained in studies involving non-adult inpatients who had few psychotic disorders and among whom there was only minimal use of p.r.n. benzodiazepines. The meaning of effectiveness was often unclear across these retrospective studies. It also appears that important outcome measures, such as duration of hospitalization, may not be affected. Administration of p.r.n. medication was also associated with a greater risk of adverse events. Future studies concerning use of p.r.n. medications in psychiatric patients should examine objective ratings of agitation, medication effects, and adverse events.
Authors:
Anil Srivastava
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of psychiatric practice     Volume:  15     ISSN:  1538-1145     ISO Abbreviation:  J Psychiatr Pract     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-22     Completed Date:  2009-08-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100901141     Medline TA:  J Psychiatr Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  193-201     Citation Subset:  IM    
Affiliation:
University of Toronto, Ontario, Canada. anilsrivastav66@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aggression / drug effects
Antipsychotic Agents / adverse effects,  therapeutic use
Benzodiazepines / adverse effects,  therapeutic use
Child
Child Development Disorders, Pervasive / drug therapy
Conduct Disorder / drug therapy
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Therapy, Combination
Hospitalization*
Humans
Mental Disorders / drug therapy*
Psychomotor Agitation / drug therapy
Psychotic Disorders / drug therapy
Psychotropic Drugs / administration & dosage*,  adverse effects
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antipsychotic Agents; 0/Psychotropic Drugs; 12794-10-4/Benzodiazepines

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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