What is it about?

We studied nurses' and patients' reasons for using "as-needed" medication for anxiety, and the use of non-drug alternatives. We found that as-needed medications were mostly used as a result of patient requests. However, the patients were not always showing symptoms of anxiety. Nurses reported attempting some form of non-drug therapy for anxiety about half the time. The reasons for using medication instead included that patients' symptoms were too intense, staff doubted that non-drug alternatives would help, and patients’ preferred to have the medication. As-needed medications were reported to be effective in most cases and side effects were usually not mentioned in the medical records. Patient interviews corroborated most staff accounts.

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Why is it important?

Taking medicine “as needed” (as opposed to regular dosages) can help with acute and changeable psychiatric symptoms, but can lead to side effects, including drug dependency and interference with regular medications. Non-drug treatments such as mindfulness-based stress reduction, emotion regulation skills, and physical activity are also effective but not often used.


Nurses might not be fully aware of non-drug therapies that are most helpful for managing and treating anxiety, suggesting that more staff training may be needed. Helping patients manage their anxiety symptoms without the use of potentially habit-forming drugs may empower them towards self-management, autonomy and recovery.

Dr N Zoe Hilton
University of Toronto

Read the Original

This page is a summary of: Staff and patient accounts of PRN medication administration and non-pharmacological interventions for anxiety, International Journal of Mental Health Nursing, May 2018, Wiley,
DOI: 10.1111/inm.12492.
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