法国儿童和青少年心理健康住院服务中按需用药的使用情况。
The use of prn medication in a child and adolescent mental health inpatient service in France.
机构信息
Department of Pharmacy, AP-HP, Hôpital Robert Debré, Paris, France, Université Paris Descartes, Paris, France.
出版信息
Int J Psychiatry Clin Pract. 2009;13(4):253-8. doi: 10.3109/13651500902849987.
Objective. The aim of this study was to investigate the use of "as needed" (pro re nata or prn) psychotropic medication in a child and adolescent psychiatric inpatient population. The study was carried out on the psychiatry ward of a paediatric teaching hospital in Paris, France. Methods. A prospective analysis of prn psychotropic drug prescriptions and administrations was conducted for all patients hospitalised over a period of 4 months. The study group consisted of 187 patients. Results. In total, 93 prn prescriptions were written, for 27% of the patients (51) but only 14% (26) received a total of 76 administrations. Antipsychotic drugs accounted for 54% of the prescriptions, anxiolytics for 33%, antiepileptic drugs for 8%, antiparkinsonian drugs for 4% and hypnotic drugs for 1%. Anxiety was the reason given for 67% of the prn administrations, with hydroxyzine used in 69% of these cases. Disruptive behaviour accounted for 22% of prn administrations, with antipsychotic drugs accounting for 88% of these administrations. Insomnia accounted for 8% of prn administrations, and antipsychotic drug-induced dystonia accounted for 3% of such administrations. Conclusion. Controlled studies are required to assess the efficacy and safety of prn medication and the conditions in which its use is indicated.
目的。本研究旨在调查在儿童和青少年精神病住院患者中按需使用（按需或 prn）精神药物的情况。该研究在法国巴黎一家儿科教学医院的精神病病房进行。
方法。对所有住院患者的 prn 精神药物处方和给药进行了为期 4 个月的前瞻性分析。研究组包括 187 名患者。
结果。共开具了 93 份 prn 处方，占 27%的患者（51 人），但只有 14%（26 人）共接受了 76 次给药。抗精神病药物占处方的 54%，抗焦虑药占 33%，抗癫痫药占 8%，抗帕金森病药占 4%，催眠药占 1%。67%的 prn 给药是因为焦虑，其中 69%使用了羟嗪。破坏性行为占 prn 给药的 22%，其中 88%使用了抗精神病药物。失眠占 prn 给药的 8%，抗精神病药引起的肌张力障碍占 3%。
结论。需要进行对照研究来评估 prn 药物的疗效和安全性，以及其使用的指征。
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