Evaluation of the use of the positive and negative syndrome scale-excited component as a criterion for administration of p.r.n. medication.
BACKGROUND
This study evaluates the use of the Positive and Negative Syndrome Scale-Excited Component (PANSS-EC) to evaluate control of agitation and aggression in inpatients with schizophrenia as a criterion for administration of p.r.n. (as needed) medication.


METHODS
Information was collected retrospectively from clinical records of patients diagnosed with schizophrenia who were admitted to Nakhonsawan Rajanakarindra Psychiatric Hospital, Nakhonsawan, Thailand 1) prior to the adoption of the PANSS-EC, when the decision to administer p.r.n. medication for agitation was based solely on individual judgment, and 2) during the period when the PANSS-EC was used during the first 3 days of admission and its scores were considered as one factor in the decision to administer p.r.n. medication.


RESULTS
The 35 patients in the group who did not receive PANSSEC assessment and the 41 patients in the group who were assessed with the PANSS-EC showed no statistically significant difference in mean number of doses of p.r.n. medication administered for agitation. However, 55.4% of all p.r.n. doses administered in the group assessed with the PANSS-EC were given during the first 3-day period (when the PANSS-EC was used), compared with 37.0% of the p.r.n. doses being administered during the first 3 days in the group not assessed with the PANSS-EC (p = 0.054). The mean number of episodes of aggression during the period of hospitalization was significantly lower in the group assessed with the PANSS-EC (p = 0.021).


CONCLUSIONS
Including the score on the PANSS-EC in the criteria used to decide whether to administer p.r.n. psychotropic medication to agitated patients with schizophrenia had an impact on staff decision-making and resulted in a more favorable clinical outcome. Further investigation is warranted to test these findings.
Chaichan
Warawat
W
Nakhonsawan Rajanakarindra Psychiatric Hospital, Phayuhakhiri, Nakhonsawan, Thailand. warawat@hotmail.com
D000208:Acute Disease; D000328:Adult; D000374:Aggression / Q000187:drug effects*; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D019091:Critical Pathways; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011595:Psychomotor Agitation / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
D014150:Antipsychotic Agents