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.