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PRN sedative prescribing in the elderly

Published online by Cambridge University Press:  02 January 2018

Rebecca Rawesh ,
Lucy Watkin  and
Vincent Kirchner
Rebecca Rawesh
Affiliation:
Royal Free and University College Rotation, Elthorne Community Mental Health Team, 17–23 Beaumont Rise, Archway, London N19 3AA, email: [email protected]
Lucy Watkin
Affiliation:
Royal Free and University College Rotation, Elthorne Community Mental Health Team, 17–23 Beaumont Rise, Archway, London N19 3AA, email: [email protected]
Vincent Kirchner
Affiliation:
Highgate Mental Health Unit
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Abstract

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Information
Psychiatric Bulletin , Volume 32 , Issue 12 , December 2008 , pp. 473
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2008

Doctors admitting elderly patients to hospital frequently prescribe sedation as required or pro re nata (prn). They may do this for a variety of reasons, including inexperience, habit and to avoid disturbing a medical colleague at night.

Here we report the results of an audit to determine the frequency of prn sedative prescribing in the elderly.

A prospective and retrospective case note and drug chart analysis of all patients admitted to the old age psychiatry wards during 3 months (1 November 2007–31 January 2008) was completed at the Highgate Mental Health Centre in North London. A total of 35 patients were admitted during this period; of these, 31 notes and drug charts (89%) were available and analysed. As many as 45% of patients were prescribed prn sedation on admission, of which only 16% (n=5) had a clear indication for sedation documented. One patient who should have been prescribed sedation, was not.

The majority of sedative prescriptions appeared to be made routinely and, therefore, inappropriately.

Further training and support for doctors, nurses and other clinical staff on wards should be encouraged to raise awareness of inappropriate prescribing of sedatives in the elderly.

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