Changing utilization of pro re nata ('as needed') sedation in a child and adolescent psychiatric inpatient unit

Dean, Angela J., McDermott, Brett M. and Scott, James (2009) Changing utilization of pro re nata ('as needed') sedation in a child and adolescent psychiatric inpatient unit. Australian and New Zealand Journal of Psychiatry, 43 4: 360-365. doi:10.1080/00048670902721095


Author Dean, Angela J.
McDermott, Brett M.
Scott, James
Title Changing utilization of pro re nata ('as needed') sedation in a child and adolescent psychiatric inpatient unit
Journal name Australian and New Zealand Journal of Psychiatry   Check publisher's open access policy
ISSN 0004-8674
Publication date 2009-04
Year available 2009
Sub-type Article (original research)
DOI 10.1080/00048670902721095
Volume 43
Issue 4
Start page 360
End page 365
Total pages 6
Editor Peter Joyce
Place of publication United Kingdom
Publisher Informa Healthcare
Collection year 2010
Language eng
Subject C1
110319 Psychiatry (incl. Psychotherapy)
111502 Clinical Pharmacology and Therapeutics
920410 Mental Health
Formatted abstract
Objective: The primary purpose of the present study was to examine changes in utilization of pro re nata (PRN; ‘as required’) sedation over time within a child and adolescent psychiatric inpatient unit. The secondary purpose was to assess whether changes in PRN sedation were related to changing patient characteristics.
Methods: A retrospective chart review examined 257 medical charts from a child and youth mental health inpatient service over two time periods (wave I, n=122; wave II, n=135) and collected data on PRN sedation, patient characteristics and routine medications.
Results: Over time a significant reduction was observed in the proportion of patients prescribed PRN sedation from 70% to 54% (p<0.01), and a reduction in the proportion of patients given PRN sedation from 46% to 26% (p<0.01). The most commonly administered drug was chlorpromazine in wave I, and diazepam in wave II. Multivariate analysis indicated that reductions in PRN sedation occurred independently of changes in patient characteristics.
Conclusions: High utilization rates of PRN sedation are not inevitable in a child and adolescent psychiatric inpatient unit and may be reduced over time. Changing utilization of PRN sedation occurred independently from changing patient characteristics. More treatment outcome studies are required to optimize use of PRN sedation in young people.
Keyword Drug utilization
Hypnotics and sedatives
Mental health services
Psychiatric hospitals
Psychotropic drugs
Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Thu, 03 Sep 2009, 08:30:06 EST by Mr Andrew Martlew on behalf of Psychiatry - Royal Brisbane and Women's Hospital