Lorazepam prescription and monitoring in acute adult psychiatric wards

Abstract

Aims and method: This study examines prescription and monitoring of lorazepam on three acute adult psychiatric wards at a university teaching hospital. Retrospective data from 102 consecutive in-patients were analysed. Results: There were 83 patients (81.4%) who were prescribed lorazepam, however 45 of these (46%) were never administered it. Indication for lorazepam prescription was documented by the doctor in 35 patients (42.2%). Administration by nursing staff was documented in the medical notes on 86 occasions (60.0%) and on 32 of these (37.0%) the indication was unclear. On 21 occasions (14.7%) more than 2 mg was given; 13.7% of prescriptions were not reviewed and 64% of those reviewed after more than 4 weeks. Clinical implications: Lorazepam was overprescribed and inadequately monitored, which may increase the risk of dependence.