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Patient Safety and Pro Re Nata Prescription and Administration: A Systematic Review

Mojtaba Vaismoradi, Sara Amaniyan, Sue Jordan Orcid Logo

Pharmacy, Volume: 6, Issue: 3, Pages: 2 - 18

Swansea University Authors: Mojtaba Vaismoradi, Sue Jordan Orcid Logo

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DOI (Published version): 10.3390/pharmacy6030095

Abstract

PRN is the acronym for ‘pro re nata,’ written against prescriptions whose administration shouldbe based on patients’ needs, rather than at set times. The aim of this systematic review was to exploresafety issues and adverse events arising from PRN prescription and administration. Electronic database...

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Published in: Pharmacy
Published: 2018
Online Access: http://www.mdpi.com/2226-4787/6/3/95
URI: https://cronfa.swan.ac.uk/Record/cronfa43591
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first_indexed 2018-08-30T13:42:45Z
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The aim of this systematic review was to exploresafety issues and adverse events arising from PRN prescription and administration. Electronic databasesincluding Scopus, PubMed [including Medline], Embase, Cinahl, Web of Science and ProQuest weresystematically searched to retrieve articles published from 2005 to 2017. Selection criteria: we included allrandomized controlled trials (RCTs) and studies with comparison groups, comparing PRN prescriptionand administration with scheduled administration, where safety issues and adverse events were reported.The authors independently assessed titles, abstracts and full-texts of retrieved studies based on inclusioncriteria and risk of bias. Results were summarised narratively. The search identified 7699 articles.Title, abstract and full-text appraisals yielded 5 articles. The included studies were RCTs with oneexception, a pre-test post-test experimental design. Patient populations, interventions and outcomesvaried. Studies compared patient-controlled or routine administration with PRN and one trial assessed theeffect of a practice guideline on implementation of PRN administration. More analgesia was administeredin the patient-controlled than the PRN arms but pain reduction was similar. However, there was littledifference in administration of psychotropic medicines. No differences between patient-controlled andPRN groups were reported for adverse events. The PRN practice guideline improved PRN patienteducation but non-documentation of PRN administration increased. This systematic review suggests thatPRN safety issues and adverse events are an under-researched area of healthcare practice. Variations inthe interventions, outcomes and clinical areas make it difficult to judge the overall quality of theevidence. Well-designed RCTs are needed to identify any safety issues and adverse events associatedwith PRN administration. 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spelling v2 43591 2018-08-30 Patient Safety and Pro Re Nata Prescription and Administration: A Systematic Review b865b33654e99f5cbccdb11350f7b069 Mojtaba Vaismoradi Mojtaba Vaismoradi true false 24ce9db29b4bde1af4e83b388aae0ea1 0000-0002-5691-2987 Sue Jordan Sue Jordan true false 2018-08-30 FGMHL PRN is the acronym for ‘pro re nata,’ written against prescriptions whose administration shouldbe based on patients’ needs, rather than at set times. The aim of this systematic review was to exploresafety issues and adverse events arising from PRN prescription and administration. Electronic databasesincluding Scopus, PubMed [including Medline], Embase, Cinahl, Web of Science and ProQuest weresystematically searched to retrieve articles published from 2005 to 2017. Selection criteria: we included allrandomized controlled trials (RCTs) and studies with comparison groups, comparing PRN prescriptionand administration with scheduled administration, where safety issues and adverse events were reported.The authors independently assessed titles, abstracts and full-texts of retrieved studies based on inclusioncriteria and risk of bias. Results were summarised narratively. The search identified 7699 articles.Title, abstract and full-text appraisals yielded 5 articles. The included studies were RCTs with oneexception, a pre-test post-test experimental design. Patient populations, interventions and outcomesvaried. Studies compared patient-controlled or routine administration with PRN and one trial assessed theeffect of a practice guideline on implementation of PRN administration. More analgesia was administeredin the patient-controlled than the PRN arms but pain reduction was similar. However, there was littledifference in administration of psychotropic medicines. No differences between patient-controlled andPRN groups were reported for adverse events. The PRN practice guideline improved PRN patienteducation but non-documentation of PRN administration increased. This systematic review suggests thatPRN safety issues and adverse events are an under-researched area of healthcare practice. Variations inthe interventions, outcomes and clinical areas make it difficult to judge the overall quality of theevidence. Well-designed RCTs are needed to identify any safety issues and adverse events associatedwith PRN administration. Available from: ttps://www.researchgate.net/publication/327286136_Patient_Safety_and_Pro_Re_Nata_Prescription_and_Administration_A_Systematic_Review/stats [accessed Aug 30 2018]. Journal Article Pharmacy 6 3 2 18 PRN ( pro re nata ); medication systems; adverse effects; patient safety; nursing 29 8 2018 2018-08-29 10.3390/pharmacy6030095 http://www.mdpi.com/2226-4787/6/3/95 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 2023-06-28T15:09:07.8040296 2018-08-30T07:01:32.1294298 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Nursing Mojtaba Vaismoradi 1 Sara Amaniyan 2 Sue Jordan 0000-0002-5691-2987 3 0043591-07092018120555.pdf 43591.pdf 2018-09-07T12:05:55.1030000 Output 851647 application/pdf Version of Record true 2018-09-06T00:00:00.0000000 Released under the terms of a Creative Commons Attribution (CC-BY) license. true eng
title Patient Safety and Pro Re Nata Prescription and Administration: A Systematic Review
spellingShingle Patient Safety and Pro Re Nata Prescription and Administration: A Systematic Review
Mojtaba Vaismoradi
Sue Jordan
title_short Patient Safety and Pro Re Nata Prescription and Administration: A Systematic Review
title_full Patient Safety and Pro Re Nata Prescription and Administration: A Systematic Review
title_fullStr Patient Safety and Pro Re Nata Prescription and Administration: A Systematic Review
title_full_unstemmed Patient Safety and Pro Re Nata Prescription and Administration: A Systematic Review
title_sort Patient Safety and Pro Re Nata Prescription and Administration: A Systematic Review
author_id_str_mv b865b33654e99f5cbccdb11350f7b069
24ce9db29b4bde1af4e83b388aae0ea1
author_id_fullname_str_mv b865b33654e99f5cbccdb11350f7b069_***_Mojtaba Vaismoradi
24ce9db29b4bde1af4e83b388aae0ea1_***_Sue Jordan
author Mojtaba Vaismoradi
Sue Jordan
author2 Mojtaba Vaismoradi
Sara Amaniyan
Sue Jordan
format Journal article
container_title Pharmacy
container_volume 6
container_issue 3
container_start_page 2
publishDate 2018
institution Swansea University
doi_str_mv 10.3390/pharmacy6030095
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
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department_str School of Health and Social Care - Nursing{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Nursing
url http://www.mdpi.com/2226-4787/6/3/95
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description PRN is the acronym for ‘pro re nata,’ written against prescriptions whose administration shouldbe based on patients’ needs, rather than at set times. The aim of this systematic review was to exploresafety issues and adverse events arising from PRN prescription and administration. Electronic databasesincluding Scopus, PubMed [including Medline], Embase, Cinahl, Web of Science and ProQuest weresystematically searched to retrieve articles published from 2005 to 2017. Selection criteria: we included allrandomized controlled trials (RCTs) and studies with comparison groups, comparing PRN prescriptionand administration with scheduled administration, where safety issues and adverse events were reported.The authors independently assessed titles, abstracts and full-texts of retrieved studies based on inclusioncriteria and risk of bias. Results were summarised narratively. The search identified 7699 articles.Title, abstract and full-text appraisals yielded 5 articles. The included studies were RCTs with oneexception, a pre-test post-test experimental design. Patient populations, interventions and outcomesvaried. Studies compared patient-controlled or routine administration with PRN and one trial assessed theeffect of a practice guideline on implementation of PRN administration. More analgesia was administeredin the patient-controlled than the PRN arms but pain reduction was similar. However, there was littledifference in administration of psychotropic medicines. No differences between patient-controlled andPRN groups were reported for adverse events. The PRN practice guideline improved PRN patienteducation but non-documentation of PRN administration increased. This systematic review suggests thatPRN safety issues and adverse events are an under-researched area of healthcare practice. Variations inthe interventions, outcomes and clinical areas make it difficult to judge the overall quality of theevidence. Well-designed RCTs are needed to identify any safety issues and adverse events associatedwith PRN administration. Available from: ttps://www.researchgate.net/publication/327286136_Patient_Safety_and_Pro_Re_Nata_Prescription_and_Administration_A_Systematic_Review/stats [accessed Aug 30 2018].
published_date 2018-08-29T15:09:03Z
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