Walker R
Department of Psychiatric Medicine, East Carolina University School of Medicine, Greenville, North Carolina 27858-4354.
Psychiatr Q. 1991 Spring;62(1):1-8. doi: 10.1007/BF01958834.
PRN psychotropic drug use is a frequent practice on psychiatric units. This study examined medical records for patient demographics and prescribing patterns of drugs. The omission of the indication and frequency of dosing for the drug were common prescribing errors. There was no significant association between diagnosis and whether a patient received PRN drugs. Anxious patients were significantly more likely to receive PRN anxiolytics whereas psychotic patients were as likely to receive PRN anxiolytics as antipsychotics. Anxiolytics also were significantly more likely to be judged effective by the nursing staff than antipsychotics. A perplexing finding was that manic and schizophrenic patients were significantly less likely to receive PRN hypnotics than were patients with Major Depression. The clinical implications of the findings are discussed and recommendations are made to improve standards of practice for this commonplace treatment.
按需使用精神药物是精神科病房的常见做法。本研究检查了病历中的患者人口统计学信息和药物处方模式。药物适应症和给药频率的遗漏是常见的处方错误。诊断与患者是否接受按需使用药物之间没有显著关联。焦虑患者显著更有可能接受按需使用的抗焦虑药,而精神病患者接受按需使用抗焦虑药的可能性与接受抗精神病药的可能性相同。与抗精神病药相比,抗焦虑药也显著更有可能被护理人员判定为有效。一个令人困惑的发现是,躁狂症和精神分裂症患者接受按需使用催眠药的可能性明显低于重度抑郁症患者。讨论了研究结果的临床意义,并提出了改进这种常见治疗方法实践标准的建议。