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Добірка наукової літератури з теми "Pro re nata medication"

Автор: Grafiati
Опубліковано: 10 грудня 2022
Оновлено: 28 січня 2023

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Статті в журналах з теми "Pro re nata medication"

1

Geffen, Josh, Lene Sorensen, Julie Stokes, Allison Cameron, Michael S. Roberts, and Laurence Geffen. "Pro Re Nata Medication for Psychoses: An Audit of Practice in Two Metropolitan Hospitals." Australian & New Zealand Journal of Psychiatry 36, no. 5 (October 2002): 649–56. http://dx.doi.org/10.1046/j.1440-1614.2002.01069.x.

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Objective: To examine the use of pro re nata (PRN) (as needed) medication in hospitalized patients with psychotic disorders. Methods: Retrospective chart reviews were conducted at two large public psychiatry units situated in inner city general hospitals. Pro re nata medication prescription, administration and outcomes were examined during inpatient episodes of care for 184 consecutive admissions of patients diagnosed with a psychotic disorder. Patient demographics, diagnoses, and regularly prescribed medication were also recorded. All admissions were drawn from a threemonth period from December 1998–February 1999. Results: The most prevalent diagnoses were schizophrenia related disorders (n = 111) and mania (n = 34). Substance use disorders (n = 49) were the most common comorbid disorders. Pro re nata medication was administered during the acute phase of 82% of admissions. Drugs prescribed Pro re nata were mostly typical antipsychotics, benzodiazepines and/or anticholinergics. Coprescription of typical antipsychotics PRN with regularly scheduled atypical antipsychotics was common (64%). Pro re nata medications accounted for 31% of the total antipsychotic dose and 28% of the total anxiolytic dose administered during acute treatment. Higher daily doses of PRN medication were given to manic patients, males, younger patients and those with substance use disorders. Pro re nata prescriptions usually specified a maximum daily dose (87%) but rarely gave indications for use (6%). Administration records frequently lacked a specified reason for use (48%) or a notation of outcome (64%). Unit staff noted medication-related morbidity in 37% of patients receiving PRN medication, compared to 3% of patients receiving only regularly scheduled medication. Extrapyramidal symptoms (EPS) were most frequently associated with administration of PRN haloperidol (Relative Risk vs other PRN medications = 5.61, 95% CI = 2.36–13.73). Conclusions: Pro re nata medications comprised a significant part of the treatment which psychotic patients received. The common practice of coprescribing PRN typical antipsychotics with scheduled atypical antipsychotics is potentially problematical since administration of PRN medication is associated with significant medication related morbidity. Preferential use of benzodiazepines as PRN agents may minimize this morbidity and foster subsequent compliance with regularly prescribed antipsychotics.
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Carder, Paula, Sheryl Zimmerman, Christopher Wretman, Sarah Dys, and Philip Sloane. "Pro Re Nata Use of Psychotropic Medications in Assisted Living." Innovation in Aging 4, Supplement_1 (December 1, 2020): 706. http://dx.doi.org/10.1093/geroni/igaa057.2482.

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Abstract This study examined the use of pro re nata (PRN, or as needed) psychotropic medications among assisted living (AL) residents. We examined prescriptions and administrations, and compared use based on dementia diagnosis. Data sources included interviews with administrators of 250 AL communities in 7 states and medication administration record review for the prior 7 days; analyses were weighted to the entire state. The percent of all residents prescribed a PRN psychotropic medication was 10.3%. However, residents with a dementia diagnosis were twice as likely to have a PRN psychotropic prescription (15.2% versus 7.2%; p<.001). The majority of psychotropic medications prescribed and administered were for anxiolytics/hypnotics rather than antipsychotics. Additional resident-level factors significantly associated with higher PRN prescribing included psychiatric diagnosis, incontinence, hospice use, confusion/disorientation, and agitation. We summarize these and other findings in the context of state regulatory requirements for staffing, chemical restraints, and dementia care.
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3

Joshi, Priyadarshan, and J. D. Collins. "Pro re nata medication: a risk factor for suicide." Psychiatric Bulletin 19, no. 8 (August 1995): 520. http://dx.doi.org/10.1192/pb.19.8.520.

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4

Nilsen, Marianne Kollerøs, Bodil H. Blix, Hege Sletvold, and Rose Mari Olsen. "Older Adults Living in Sheltered Housing’s Experiences of Involvement in Pro Re Nata Decisions. A Narrative Positioning Analysis." Global Qualitative Nursing Research 8 (January 2021): 233339362110569. http://dx.doi.org/10.1177/23333936211056930.

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Анотація:
Decisions regarding pro re nata medications might be challenging due to the complex nature of the practice. The aim of this study was to expand our understanding of the experiences of older people living in sheltered housings with regard to shared decision-making concerning pro re nata medications. In this study, we conducted in-depth interviews with residents living in Norwegian sheltered housings. The analysis was inductive, based on a narrative positioning analysis. Twelve residents were interviewed, and three narratives representing participants’ variation are presented. People take different positions in shared decision-making of pro re nata medication, and they position themselves variously at different levels and situations. Prevailing master narratives affect the residents’ positions in shared decision-making. Contrasts in older adults’ experiences indicate that shared decision-making is not straightforward and is highly reliant on the context. Seemingly, they wish to be involved and not involved at the same time, a contradiction that healthcare providers need to consider.
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Hilton, Michael F., and Harvey A. Whiteford. "Pro Re Nata Medication for Psychiatric Inpatients: Time to Act." Australian & New Zealand Journal of Psychiatry 42, no. 7 (January 2008): 555–64. http://dx.doi.org/10.1080/00048670802119804.

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6

Geffen, Josh, Allison Cameron, Lene Sorensen, Julie Stokes, Michael S. Roberts, and Laurence Geffen. "Pro Re Nata Medication for Psychoses: The Knowledge and Beliefs of Doctors and Nurses." Australian & New Zealand Journal of Psychiatry 36, no. 5 (October 2002): 642–48. http://dx.doi.org/10.1046/j.1440-1614.2002.01068.x.

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Objective: To examine the knowledge and beliefs of doctors and nurses in inpatient psychiatric units about pro re nata (PRN) (as needed) medications for psychotic disorders. Methods: Medical (n = 44) and nursing (n = 80) staff in two metropolitan public hospital units completed a structured questionnaire about their use of PRN psychotropic medications on one occasion during the four months from March–June 1999. Results: Nurses selected more indications for PRN antipsychotics than doctors (3.49 vs 2.72, p < 0.05), whereas doctors selected more indications for PRN benzodiazepines (3.77 vs 3.19, p < 0.05). The groups did not differ in the number of selected indications for using anticholinergics. For agitation, the majority of nurses viewed both benzodiazepines (56%) and antipsychotics (86%) as effective, with 60% preferring an antipsychotic. For the acute control of psychotic symptoms, 99% of nurses believed antipsychotics were effective and 58% benzodiazepines, with 87% preferring an antipsychotic. A large majority of doctors viewed both PRN benzodiazepines, 94%, and antipsychotics, 81%, as effective for agitation, and 55% preferred to use a benzodiazepine. For psychotic symptoms, 80% believed PRN antipsychotics were effective, but only 32% viewed benzodiazepines as effective, and 64% preferred to use an antipsychotic. Nursing staff identified more non-pharmacological techniques for managing both agitation and psychotic symptoms and reported using these more often than doctors. Junior staff, both nursing and medical, had less knowledge of nonpharmacological alternatives to PRN medication than senior staff. Conclusions: Disparities existed between doctors and nurses views on the indications for PRN medication in the acute management of psychoses, thus it is important for doctors to specify indications when writing PRN prescriptions. Despite evidence for the safety and effectiveness of benzodiazepines, there was widespread reluctance to use them as PRN medication in acute psychoses. Beliefs of some staff about PRN medications were at odds with the known properties of these medicines. Educational interventions for both nurses and doctors are required to achieve best practice in PRN medication.
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Mohandas, Rajesh, Gajapathiraju Chamarthi, Shahab Bozorgmehri, Jeremy Carlson, Tezcan Ozrazgat-Baslanti, Rupam Ruchi, Ashutosh Shukla, et al. "Pro Re Nata Antihypertensive Medications and Adverse Outcomes in Hospitalized Patients: A Propensity-Matched Cohort Study." Hypertension 78, no. 2 (August 2021): 516–24. http://dx.doi.org/10.1161/hypertensionaha.121.17279.

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Physicians routinely order blood pressure (BP) medications on an as needed basis or pro re nata to control BPs in hospitalized patients. We hypothesized that treatment of inpatients, who do not have a hypertensive emergency, with the use of antihypertensive medication on an as needed basis could lead to adverse outcomes. Four thousand two hundred nineteen patients who received BP medications on an as needed basis in addition to scheduled antihypertensive medications were matched 1:1 using propensity matching to those who received only scheduled BP medications. Compared with the propensity-matched cohort, patients who received antihypertensive medications on an as needed basis were more likely to experience abrupt lowering of systolic BPs (odds ratio, 2.05 [95% CI, 1.56–2.71], P <0.001), acute kidney injury (odds ratio, 1.24 [95% CI, 1.09–1.42], P =0.002), and ischemic stroke (odds ratio, 8.5 [95% CI, 1.96–36.79]; P <0.001). The use of as needed antihypertensive medication was also associated with increased in-hospital mortality (odds ratio, 2.36 [95% CI, 1.26–4.41]; P =0.001) and an increase in the median length of stay (4.7 versus 2.9 days; P <0.001). In addition, ischemic events were more likely in those who had an abrupt drop in BPs, and the risk was increased in proportion to the number of doses of as needed BP medications administered. The use of as needed antihypertensive medication is associated with an abrupt drop in BPs, increased risk of ischemic events, in-hospital mortality, and longer length of stay. We suggest that the routine use of as needed antihypertensive medication should be discouraged.
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Carlson, Gabrielle A., Lauren Spring, and Joseph E. Schwartz. "Does Pro Re Nata Oral Medication Shorten Outburst Duration in Children?" Journal of the American Academy of Child & Adolescent Psychiatry 61, no. 2 (February 2022): 111–14. http://dx.doi.org/10.1016/j.jaac.2021.09.415.

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Saito, Ema, Stephanie Eng, Christine Grosso, Zeynep Ozinci, and Anna Van Meter. "Pro Re Nata Medication Use in Acute Care Adolescent Psychiatric Unit." Journal of Child and Adolescent Psychopharmacology 30, no. 4 (May 1, 2020): 250–60. http://dx.doi.org/10.1089/cap.2019.0131.

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Reddy, H. "Audit of prescribing of PRN (pro re nata) medications." European Psychiatry 23 (April 2008): S342—S343. http://dx.doi.org/10.1016/j.eurpsy.2008.01.1184.

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Дисертації з теми "Pro re nata medication"

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Glasmeyer, Sabeth Wiebeke [Verfasser], and Thomas [Akademischer Betreuer] Bein. "Gender-specific differences in nursing staff's administration patterns of 'pro re nata' medication: A prospective observational study. / Sabeth Wiebeke Glasmeyer ; Betreuer: Thomas Bein." Regensburg : Universitätsbibliothek Regensburg, 2018. http://d-nb.info/1170955770/34.

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Murray, Lorraine Odette. "The role of the registered nurse managing pro re nata (PRN) medicines in the care home (nursing) : a case study of decision-making, medication management and resident involvement." Thesis, University of Hertfordshire, 2017. http://hdl.handle.net/2299/17989.

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Анотація:
The aim of this study was to analyse the role of the registered nurse in the management of pro re nata (PRN) medication in a care home (nursing) for older people. Studying PRN medication provides insights into the role of the nurse in care homes (nursing) who act as assessor, decision maker and evaluator in residents' care. It also provides a lens by which to explore how residents and their carers interact and participate in day-to-day care decisions about residents' health. The case study draws on ethnography. It is a multi-method study, using documentary and medication reviews, observations and interviews to answer the research questions. Thirty-four residents were recruited to the study and 60 care home staff. Findings showed that 88.2% of residents (n=30) were prescribed PRN medication and that all residents were on a minimum of 1 and a maximum of 7 medication. During each 28-day MAR sheet period between 35 and 44 PRN prescriptions were written. They contributed 12.7% of all medication prescribed, accounting for between 1.2 and 1.5 medication per resident. Nurses were found to administer PRN medication, but a finding of this study was that this activity could be delegated to carers who were identifying resident needs. There was some evidence of resident engagement but this was often a three-way process between resident, GP and family or resident, carer and nurse. A percentage of medication that could have been PRN were routinely prescribed. Observations also identified that nurses would decide not to administer routine medication in certain circumstances and that this was directly related to their assessment of the resident. The process of medication management was dominated by the regulations and governance processes of the care home. Observations and interviews found that care home staff recognised and affirmed residents' pain but did not take action for analgesia to be administered. They were familiar with the use of pain assessment tools for older people living with dementia and had received training in dementia care. Many of the staff were also able to interpret signs and symptoms of a resident's distress. Nevertheless, their preoccupation with meeting internal and external regulator standards was a barrier to addressing residents' needs. This is the first study that has looked at an aspect of medication management to understand how nurses and care home staff work for and with residents to moderate and address their health care needs. It suggests that additional training in aspects of medication management and resident assessment may not be able to address deeper seated issues of autonomy and how the nursing role is understood and enacted in care home settings.
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Morkunas, Bernadette. "The experiences of mental health professionals and patients in the use of pro re nata medication in acute adult mental health care settings: a systematic review of qualitative evidence." Thesis, 2016. http://hdl.handle.net/2440/103474.

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Анотація:
The use of pro re nata (PRN) medication, a medication that is given when needed, as opposed to medication that is given at a regular time, is surrounded by claims of misuse and poor accountability within the mental health setting. Gaining insight and understanding into the experiences of health professionals and patients in the use of PRN medication will assist in contributing to improving education and safety around this common intervention. The objective was to synthesize the best available evidence of qualitative research that looked at the experiences of mental health professionals and patients in the use of PRN medication in acute adult mental health care settings. The review considered studies that included mental health professionals who were working in an acute adult mental health care setting as well as adults who were admitted into an acute adult mental health care setting. The phenomena of interest was the experience of the mental health professionals and patients in the use of PRN medication in acute adult mental health care settings. Studies that focused on qualitative data including, but was not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered. The databases searched included: CINAHL, PubMed, Embase, Scopus, PsycINFO and the search for unpublished studies included: Proquest Dissertation and Theses, Mednar and Google Scholar. Qualitative research findings were pooled using the Joanna Briggs Institute Qualitative Assessment Review Instrument (JBI-QARI). This involved the aggregation or synthesis of findings to generate a set of statements that represented that aggregation through assembling the findings rated according to their quality, and categorizing these findings on the basis of a similarity in meaning. Categories were then subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings that can be used as a basis for evidence-based practice. Studies published in the English language were considered for inclusion. Literature from the last 30 years was searched to ensure currency and relevance of the research. Four studies were included in the systematic review. Two studies each from both groups’ perspective. These experiences were combined in one synthesis to look at the issues from mutual perspectives. A total of forty findings were extracted. The findings were grouped into ten categories and five synthesized findings were developed. The findings demonstrated that PRN medication use among mental health professionals and service users is subject to many variables such as individual decision making to organizational policies. The findings also showed there are many contributing factors to the prescribing and administering of PRN medications. Patients had views and opinions on their use of PRN medication describing that they found PRN medication to be useful in helping them to take control of their symptoms and that education around alternatives to PRN medication administration should be offered.
Thesis (M.Clin.Sc.) -- University of Adelaide, Joanna Briggs Institute, 2016.
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4

Carneiro, João Nuno Romano. "Real world comparison of the treatment regimens in neovascular age-related macular degeneration: effectiveness of treat-and-extend vs pro re nata." Master's thesis, 2019. https://hdl.handle.net/10216/119892.

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Carneiro, João Nuno Romano. "Real world comparison of the treatment regimens in neovascular age-related macular degeneration: effectiveness of treat-and-extend vs pro re nata." Dissertação, 2019. https://hdl.handle.net/10216/119892.

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Частини книг з теми "Pro re nata medication"

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Nilsen, Marianne Kollerøs, and Hege Therese Bell. "A Tool to Ensure Appropriate Drug Use and Maintain Patient Safety When Administering Pro Re Nata Medications: Healthcare Providers’ Experiences With Medicine Lists in Sheltered Housing for Older People." In Medication Safety in Municipal Health and Care Services, 237–57. Cappelen Damm Akademisk/NOASP, 2022. http://dx.doi.org/10.23865/noasp.172.ch11.

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Residents living in sheltered housing may need assistance with the administration of medications, including medications used as needed. Healthcare providers can then administer medications based on the resident’s medication list. The aim of this study is to expand our understanding of how healthcare providers utilize medication lists in managing pro re nata medications. Based on a secondary analysis of qualitative data, we found that medication lists are important tools to ensure appropriate medication use, and to maintain patient safety in sheltered housing. The results show that the interviewees expected updated and unambiguous medication lists in order to safeguard uniform practice, and maintain confidence in the administration of pro re nata medications. However, they often experienced ambiguous medication lists, putting a strain on quality of care. To manage updated medication lists and provide safe administration of pro re nata medications, the interviewees asked for closer collaboration with general practitioners, in which case medication reviews could be a solution.
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John Stones, Michael, Jason Randle, and Peter Brink. "Effects of Antipsychotic Medication on Mortality in Long-Term Care Home Residents." In Palliative Care [Working Title]. IntechOpen, 2020. http://dx.doi.org/10.5772/intechopen.95388.

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This chapter examines mortality in long-term care home (LTCH) residents as associated with the use antipsychotic medication when combined with other psychotropic medications. The data at census-level pertain to all new admissions to long-term care homes (LTCH) in Ontario, Canada, during a given financial year (i.e., over 20,000 LTCH residents). The observations include comprehensive assessment upon admission and at quarterly intervals thereafter for a maximal period of 1-year after the initial assessment. The mortality data derive from three linked databases, with mortality classified as death within 90 days of the final assessment. The findings indicate that combinations of concurrent daily usage of antipsychotic medication with daily usage of other psychotropic medications (particularly antidepressants and analgesics) are associated with relatively low mortality, whereas intermittent usage (e.g. pro re nata; as needed) is associated with relatively high mortality.
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John Stones, Michael, Jason Randle, and Peter Brink. "Effects of Antipsychotic Medication on Mortality in Long-Term Care Home Residents." In Suggestions for Addressing Clinical and Non-Clinical Issues in Palliative Care. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.95388.

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Анотація:
This chapter examines mortality in long-term care home (LTCH) residents as associated with the use antipsychotic medication when combined with other psychotropic medications. The data at census-level pertain to all new admissions to long-term care homes (LTCH) in Ontario, Canada, during a given financial year (i.e., over 20,000 LTCH residents). The observations include comprehensive assessment upon admission and at quarterly intervals thereafter for a maximal period of 1-year after the initial assessment. The mortality data derive from three linked databases, with mortality classified as death within 90 days of the final assessment. The findings indicate that combinations of concurrent daily usage of antipsychotic medication with daily usage of other psychotropic medications (particularly antidepressants and analgesics) are associated with relatively low mortality, whereas intermittent usage (e.g. pro re nata; as needed) is associated with relatively high mortality.
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"Pro Re Nata." In Encyclopedia of Pain, 3187. Berlin, Heidelberg: Springer Berlin Heidelberg, 2013. http://dx.doi.org/10.1007/978-3-642-28753-4_201773.

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