Trajectories of pro re nata (PRN) medication prescribing and administration in long-term care facilities

Monica Sharma; Xin Yee Wong; J Simon Bell; Megan Corlis; Michelle Hogan; Janet K Sluggett

doi:10.1016/j.sapharm.2020.11.003

Trajectories of pro re nata (PRN) medication prescribing and administration in long-term care facilities

Res Social Adm Pharm. 2021 Aug;17(8):1463-1468. doi: 10.1016/j.sapharm.2020.11.003. Epub 2020 Nov 10.

Authors

Monica Sharma¹, Xin Yee Wong¹, J Simon Bell², Megan Corlis³, Michelle Hogan⁴, Janet K Sluggett⁵

Affiliations

¹ University of South Australia, UniSA Clinical and Health Sciences, Adelaide, South Australia, Australia.
² 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.
³ University of South Australia, UniSA Allied Health and Human Performance, Adelaide, South Australia, Australia.
⁴ Helping Hand Aged Care, North Adelaide, South Australia, Australia.
⁵ Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; University of South Australia, UniSA Allied Health and Human Performance, Adelaide, South Australia, Australia; Registry of Senior Australians (ROSA), Health Ageing Research Consortium, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia. Electronic address: janet.sluggett@unisa.edu.au.

PMID: 33223395
DOI: 10.1016/j.sapharm.2020.11.003

Abstract

Background: Little is known about changes in pro re nata (PRN) medication prescribing and administration in residential aged care facilities (RACFs) over time.

Objective: To determine the prevalence and factors associated with PRN medication administration in RACFs and examine changes over 12-months.

Methods: Secondary analyses utilizing data from the SIMPLER randomized controlled trial (n = 242 residents, 8 RACFs) was undertaken. PRN medication data were extracted from RACF medication charts. Factors associated with PRN medication administration in the preceding week were explored using multivariable logistic regression.

Results: At baseline, 211 residents (87.2%) were prescribed ≥1 PRN medication, with 77 (36.5%) administered PRN medication in the preceding week. PRN administration was more likely in non-metropolitan areas, and less likely among residents with more severe dementia symptoms and greater dependence with activities of daily living. No significant differences in overall PRN prescribing or administration in 162 residents alive at 12-month follow-up were observed.

Conclusions: Despite being frequently prescribed, the contribution of PRNs to overall medication use in RACFs is small. PRN prescribing and administration was relatively static over 12-months despite likely changes in resident health status over this period, suggesting further exploration of PRN prescribing in relation to resident care needs may be warranted.

Keywords: Long-term care; Medication administration; Medication management; Nursing homes; Pro re nata; Residential aged care.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living
Aged
Dementia*
Drug Prescriptions
Humans
Long-Term Care*
Skilled Nursing Facilities