Pro Re Nata Medication Use in Acute Care Adolescent Psychiatric Unit

Area of Science:

• Psychiatry
• Adolescent Medicine
• Clinical Pharmacology

Background:

• Limited evidence supports pro re nata (PRN) medication use, especially in youth.
• Details on PRN indication, frequency, and patient characteristics are scarce.
• Acute care psychiatric units commonly utilize PRN for symptom management.

Purpose of the Study:

• To investigate the patterns of PRN medication use over six years in an adolescent acute care psychiatric unit.
• To identify factors associated with PRN medication administration in this population.

Main Methods:

• Retrospective chart review of 3937 admissions for 2961 adolescents (Nov 2012-Oct 2018).
• Extraction of demographic, clinical, and medication administration data from electronic medical records.
• Analysis of psychotropic and nonpsychotropic PRN use, timing, and associated variables.

Main Results:

• 62% of admissions involved at least one PRN medication administration.
• High PRN use was linked to symptom severity, longer length of stay, and readmission.
• Adolescents with bipolar spectrum disorders received more PRN medications; high psychotropic PRN users also used more nonpsychotropic PRN.

Conclusions:

• PRN medications are prevalent in adolescent inpatient psychiatric settings despite limited evidence.
• Frequent use of both psychotropic and nonpsychotropic PRN in severe cases suggests potential systemic issues in youth mental illness.
• Further research is essential to evaluate the efficacy of PRN medications for specific symptom management.