一项关于在住院心理健康环境中按需使用精神药物的最佳证据综合综述。
A best-evidence synthesis review of the administration of psychotropic pro re nata (PRN) medication in in-patient mental health settings.
作者信息
Baker John A, Lovell Karina, Harris Neil
机构信息
School of Nursing, Midwifery and Social Work, University of Manchester, UK.
出版信息
J Clin Nurs. 2008 May;17(9):1122-31. doi: 10.1111/j.1365-2702.2007.02236.x.
AIMS AND OBJECTIVES
This paper aims to synthesise published literature of drug use/administration studies of pro re nata psychotropic medications in mental health wards.
DESIGN
The study employed a best-evidence synthesis review design.
BACKGROUND
The administration of psychotropic pro re nata medications is a frequently used clinical intervention in mental health wards. Pro re nata contributes to exposing patients to high doses of antipsychotic medication. Despite the frequent use of pro re nata, there is limited evidence of their effectiveness.
METHODS
A best-evidence synthesis review.
RESULTS
Six major themes emerged from the literature: (i) frequency of administration; (ii) administration during the 24-hour day; (iii) administration associated with length and stage of admission; (iv) rationales for administration; (v) medicines administered (including route of administration); and (vi) effects and side effects of the medicines administered.
CONCLUSIONS
Overall findings indicate that the administration of psychotropic pro re nata varies radically and appears to be influenced by many variables. Relevance to clinical practice. Patients are most likely to receive a benzodiazepine or typical antipsychotic as pro re nata. Pro re nata is an important and under-researched clinical intervention used in mental health wards.
目的与目标
本文旨在综合已发表的关于精神科病房按需使用精神药物的药物使用/给药研究文献。
设计
本研究采用最佳证据综合评价设计。
背景
按需使用精神药物是精神科病房常用的临床干预措施。按需使用会使患者暴露于高剂量抗精神病药物中。尽管按需使用很频繁,但其有效性的证据有限。
方法
进行最佳证据综合评价。
结果
文献中出现了六个主要主题:(i)给药频率;(ii)24小时内的给药情况;(iii)与住院时长和阶段相关的给药;(iv)给药理由;(v)所使用的药物(包括给药途径);以及(vi)所使用药物的效果和副作用。
结论
总体研究结果表明,按需使用精神药物的情况差异很大,且似乎受多种变量影响。与临床实践的相关性。患者最有可能按需接受苯二氮䓬类药物或典型抗精神病药物。按需使用是精神科病房使用的一种重要且研究不足的临床干预措施。