Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia.
Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; NHMRC Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Hornsby, New South Wales, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia.
Res Social Adm Pharm. 2018 Oct;14(10):964-967. doi: 10.1016/j.sapharm.2017.11.004. Epub 2017 Nov 7.
Little is known about the contribution of 'pro re nata' (PRN) medications to overall medication burden in residential aged care services (RACS).
To determine the frequency of, and factors associated with PRN medication administration in RACS.
Details of all medications charted for regular or PRN use were extracted from medication charts for 383 residents of 6 Australian RACS. Records of medications administered over a 7 day period were also extracted. Factors associated with PRN medication administration among residents charted ≥1 PRN were determined using multivariate logistic regression.
Of the 360 (94%) residents charted ≥1 PRN medication, 99 (28%) were administered PRN medication at least once. The most prevalent PRN medications were analgesics and laxatives. Residents with greater dependence with activities of daily living (ADL) (adjusted odds ratio (aOR) per additional point on Katz ADL scale: 0.80; 95% confidence interval (CI) 0.72-0.89; p < 0.001) and a greater number of regular medications (aOR per additional medication: 1.06; 95% CI 1.00-1.13; p = 0.042) were more likely to be administered PRN medication.
Although most residents are charted PRN medications, rates of administration are relatively low, suggesting the contribution of PRNs to medication burden in RACS may be lower than previously thought.
关于“按需”（PRN）药物对养老院服务（RACS）整体药物负担的贡献，知之甚少。
确定 RACS 中 PRN 药物给药的频率和相关因素。
从 6 家澳大利亚 RACS 中 383 名居民的用药图表中提取了所有常规或 PRN 使用药物的详细信息。还提取了在 7 天内给药的药物记录。使用多变量逻辑回归确定与 ≥1 项 PRN 图表记录的居民中 PRN 药物给药相关的因素。
在记录了 ≥1 项 PRN 药物的 360 名（94%）居民中，有 99 名（28%）至少使用过一次 PRN 药物。最常见的 PRN 药物是止痛药和泻药。日常生活活动（ADL）依赖性较高的居民（Katz ADL 量表每增加 1 分的调整优势比（aOR）：0.80；95%置信区间（CI）0.72-0.89；p<0.001）和更多常规药物（每增加一种药物的 aOR：1.06；95%CI 1.00-1.13；p=0.042）更有可能使用 PRN 药物。
尽管大多数居民都开具了 PRN 药物，但给药率相对较低，这表明 PRN 对 RACS 药物负担的贡献可能低于先前认为的那样。
