Jacquelina Stasinopoulos1, J Simon Bell2, Taliesin E Ryan-Atwood3, Edwin C K Tan4, Jenni Ilomäki5, Tina Cooper6, Leonie Robson7, Janet K Sluggett8. 1. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia. Electronic address: jaco2@student.monash.edu. 2. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; NHMRC Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Hornsby, New South Wales, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia. Electronic address: simon.bell2@monash.edu. 3. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia. Electronic address: taliesin.ryan.atwood@monash.edu. 4. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden. Electronic address: edwin.tan@monash.edu. 5. 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. Electronic address: jenni.ilomaki@monash.edu. 6. Resthaven Incorporated, Adelaide, South Australia, Australia. Electronic address: TCooper@resthaven.asn.au. 7. Resthaven Incorporated, Adelaide, South Australia, Australia. Electronic address: LRobson@resthaven.asn.au. 8. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; NHMRC Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Hornsby, New South Wales, Australia. Electronic address: janet.sluggett@monash.edu.
Abstract
BACKGROUND: Little is known about the contribution of 'pro re nata' (PRN) medications to overall medication burden in residential aged care services (RACS). OBJECTIVES: To determine the frequency of, and factors associated with PRN medication administration in RACS. MEASUREMENTS: Details of all medications charted for regular or PRN use were extracted from medication charts for 383 residents of 6 Australian RACS. Records of medications administered over a 7 day period were also extracted. Factors associated with PRN medication administration among residents charted ≥1 PRN were determined using multivariate logistic regression. RESULTS: Of the 360 (94%) residents charted ≥1 PRN medication, 99 (28%) were administered PRN medication at least once. The most prevalent PRN medications were analgesics and laxatives. Residents with greater dependence with activities of daily living (ADL) (adjusted odds ratio (aOR) per additional point on Katz ADL scale: 0.80; 95% confidence interval (CI) 0.72-0.89; p < 0.001) and a greater number of regular medications (aOR per additional medication: 1.06; 95% CI 1.00-1.13; p = 0.042) were more likely to be administered PRN medication. CONCLUSIONS: Although most residents are charted PRN medications, rates of administration are relatively low, suggesting the contribution of PRNs to medication burden in RACS may be lower than previously thought.
BACKGROUND: Little is known about the contribution of 'pro re nata' (PRN) medications to overall medication burden in residential aged care services (RACS). OBJECTIVES: To determine the frequency of, and factors associated with PRN medication administration in RACS. MEASUREMENTS: Details of all medications charted for regular or PRN use were extracted from medication charts for 383 residents of 6 Australian RACS. Records of medications administered over a 7 day period were also extracted. Factors associated with PRN medication administration among residents charted ≥1 PRN were determined using multivariate logistic regression. RESULTS: Of the 360 (94%) residents charted ≥1 PRN medication, 99 (28%) were administered PRN medication at least once. The most prevalent PRN medications were analgesics and laxatives. Residents with greater dependence with activities of daily living (ADL) (adjusted odds ratio (aOR) per additional point on Katz ADL scale: 0.80; 95% confidence interval (CI) 0.72-0.89; p < 0.001) and a greater number of regular medications (aOR per additional medication: 1.06; 95% CI 1.00-1.13; p = 0.042) were more likely to be administered PRN medication. CONCLUSIONS: Although most residents are charted PRN medications, rates of administration are relatively low, suggesting the contribution of PRNs to medication burden in RACS may be lower than previously thought.
Authors: Paula Carder; Sheryl Zimmerman; Christopher J Wretman; John S Preisser; Sarah Dys; Philip D Sloane Journal: J Am Med Dir Assoc Date: 2021-12-14 Impact factor: 7.802
Authors: Alys W Griffiths; Claire A Surr; David P Alldred; John Baker; Ruchi Higham; Karen Spilsbury; Carl A Thompson Journal: Int J Clin Pharm Date: 2019-07-24