PRN sedation-patterns of prescribing and administration in a child and adolescent mental health inpatient service.
OBJECTIVE
To identify utilisation rates of prn (pro re nata) sedation in children and adolescents receiving inpatient psychiatric treatment, and to compare correlates of prn prescribing and administration.


METHODS
A retrospective chart review examined 122 medical charts from a child and youth mental health inpatient service.


RESULTS
71.3% of patients were prescribed prn sedation and 50.8% were administered prn sedation. Patients received an average of 8.0 doses of prn sedation, with 9.8% receiving 10 or more doses. Chlorpromazine and diazepam were the most commonly utilised agents. Prescribing of prn sedation was only related to use of regular medications (p < 0.01), and non-parent carers (p < 0.01). In contrast, administration of prn sedation was associated with multiple diagnoses (p < 0.01), pervasive development disorder (p < 0.01), mental retardation (p < 0.01) ADHD (p < 0.01), longer hospital admission (p < 0.01), use of atypical antipsychotics (p < 0.01) and polypharmacy (p < 0.01).


CONCLUSIONS
Despite lack of data to inform practice, prn sedation is widely utilised, especially in complex patients. Future research in this area needs to incorporate nurses and examine whether patients benefit from prn sedation, which drugs and dosing patterns optimise safety and efficacy, and what is the role of prn sedation in the context of other medication.
Kids in Mind Research, Mater Child and Youth Mental Health Service, 4101, South Brisbane , QLD, Australia. Angela.Dean@mater.org.au
Angela J
AJ
Dean
Brett M
BM
McDermott
Robert T
RT
Marshall
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003710:Demography; D004334:Drug Administration Schedule; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004358:Drug Therapy / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D011595:Psychomotor Agitation / Q000188:drug therapy* / Q000534:rehabilitation*; D012189:Retrospective Studies
D006993:Hypnotics and Sedatives