Vaismoradi Mojtaba, Vizcaya Moreno Flores, Sletvold Hege, Jordan Sue
Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway.
Faculty of Health Sciences, University of Alicante, E-03080 Alicante, Spain.
Pharmacy (Basel). 2019 Nov 25;7(4):157. doi: 10.3390/pharmacy7040157.
Many medications are prescribed and administered PRN (, as needed). However, there are few integrative reviews to inform PRN psychotropic medication use in long-term care facilities and nursing or care homes. Accordingly, this integrative systematic review aimed to improve our understanding of PRN medicines management with a focus on psychotropic medications (antipsychotics, sedatives, anxiolytics, and hypnotics) in long-term care settings. Keywords relating to PRN in English, Norwegian, and Spanish were used, and articles published between 2009 and 2019 were retrieved. Based on the inclusion criteria, eight articles were used for data analysis and synthesis. This review offers a description of PRN prescription and administration of psychotropic medications in long-term care. Variations were observed in the management of PRN psychotropic medications based on residents' underlying health conditions and needs, duration of use, and changes between medications and doses. Neither the reasons for PRN prescription and administration nor the steps taken to identify and manage any associated adverse reactions or adverse drug events were reported. Further initiatives are needed to improve PRN medicines management to explore factors that affect PRN prescription and administration and to develop appropriate PRN guidelines to prevent harm and improve the safety of people living in long-term care facilities.
许多药物是根据需要（PRN）开具和使用的。然而，关于长期护理机构和疗养院中按需使用精神药物的综合综述很少。因此，本综合系统综述旨在加深我们对按需用药管理的理解，重点关注长期护理环境中的精神药物（抗精神病药、镇静剂、抗焦虑药和催眠药）。使用了与英文、挪威文和西班牙文中按需用药相关的关键词，并检索了2009年至2019年发表的文章。根据纳入标准，八篇文章用于数据分析和综合。本综述描述了长期护理中按需使用精神药物的处方和用药情况。根据居民的潜在健康状况和需求、使用时长以及药物和剂量的变化，按需使用精神药物的管理存在差异。未报告按需处方和用药的原因，也未报告识别和管理任何相关不良反应或药物不良事件所采取的步骤。需要进一步采取措施来改善按需用药管理，以探索影响按需处方和用药的因素，并制定适当的按需用药指南，以预防伤害并提高长期护理机构居民的安全性。
