A best-evidence synthesis review of the administration of psychotropic pro re nata (PRN) medication in in-patient mental health settings

Aims and objectives. This paper aims to synthesise published literature of drug use/administration studies of pro re nata psychotropic medications in mental health wards. Design. The study employed a best-evidence synthesis review design. Backgroud. The administration of psychotropic pro re nata medications is a frequently used clinical intervention in mental health wards. Pro re nata contributes to exposing patients to high doses of antipsychotic medication. Despite the frequent use of pro re nata, there is limited evidence of their effectiveness. Methods. A best-evidence synthesis review. Results. Six major themes emerged from the literature: (i) frequency of administration; (ii) administration during the 24-hour day; (iii) administration associated with length and stage of admission; (iv) rationales for administration; (v) medicines administered (including route of administration); and (vi) effects and side effects of the medicines administered. Conclusions. Overall findings indicate that the administration of psychotropic pro re nata varies radically and appears to be influenced by many variables. Relevance to clinical pratice. Patients are most likely to receive a benzodiazepine or typical antipsychotic as pro re nata. Pro re nata is an important and under-researched clinical intervention used in mental health wards.