University of South Australia, UniSA Clinical and Health Sciences, Adelaide, South Australia, Australia.
Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Res Social Adm Pharm. 2021 Aug;17(8):1463-1468. doi: 10.1016/j.sapharm.2020.11.003. Epub 2020 Nov 10.
Little is known about changes in pro re nata (PRN) medication prescribing and administration in residential aged care facilities (RACFs) over time.
To determine the prevalence and factors associated with PRN medication administration in RACFs and examine changes over 12-months.
Secondary analyses utilizing data from the SIMPLER randomized controlled trial (n = 242 residents, 8 RACFs) was undertaken. PRN medication data were extracted from RACF medication charts. Factors associated with PRN medication administration in the preceding week were explored using multivariable logistic regression.
At baseline, 211 residents (87.2%) were prescribed ≥1 PRN medication, with 77 (36.5%) administered PRN medication in the preceding week. PRN administration was more likely in non-metropolitan areas, and less likely among residents with more severe dementia symptoms and greater dependence with activities of daily living. No significant differences in overall PRN prescribing or administration in 162 residents alive at 12-month follow-up were observed.
Despite being frequently prescribed, the contribution of PRNs to overall medication use in RACFs is small. PRN prescribing and administration was relatively static over 12-months despite likely changes in resident health status over this period, suggesting further exploration of PRN prescribing in relation to resident care needs may be warranted.
对于长期护理机构（RACF）中按需（PRN）药物处方和管理随时间的变化知之甚少。
确定 RACF 中 PRN 药物管理的流行率和相关因素，并检查 12 个月内的变化。
利用 SIMPLER 随机对照试验（n=242 名居民，8 个 RACF）的数据进行二次分析。从 RACF 药物图表中提取 PRN 药物数据。使用多变量逻辑回归探讨与前一周 PRN 药物管理相关的因素。
基线时，211 名居民（87.2%）开了至少一种 PRN 药物，其中 77 名（36.5%）在前一周内给予了 PRN 药物。在非城市地区，PRN 给药的可能性更大，而在痴呆症状更严重和日常生活活动依赖性更大的居民中，PRN 给药的可能性更小。在 12 个月随访时仍存活的 162 名居民中，总体 PRN 处方或管理没有明显差异。
尽管 PRN 经常开处方，但它们对 RACF 中整体药物使用的贡献很小。尽管在此期间居民的健康状况可能发生了变化，但 PRN 处方和管理在 12 个月内相对稳定，这表明可能需要进一步探索 PRN 处方与居民护理需求之间的关系。
