Naproxen Twice Daily Versus as Needed (PRN) Dosing: Efficacy and Tolerability for Treatment of Acute Ankle Sprain, a Randomized Clinical Trial

Hajimaghsoudi, Majid; Jalili, Mohammad; Mokhtari, Mehdi; Nejati, Amir; Mesbahi, Javad; Paydary, Koosha

doi:10.5812/asjsm.11411

Cited by 5 publications

(15 citation statements)

References 14 publications

(18 reference statements)

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“…Contradicting results have been reported on the effect of diclofenac for pain during rest, swelling and inflammation, 98 101. No differences in effect were seen when comparing a fixed dosage (500 mg two times daily) to an as-needed naproxen dosage (one RCT, n=135, MD pain −0.13 (−0.38 to 0.12))106 (level 3). Despite dose differences, paracetamol (cq.…”

Section: Resultsmentioning

confidence: 99%

Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline

et al. 2018

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This guideline aimed to advance current understandings regarding the diagnosis, prevention and therapeutic interventions for ankle sprains by updating the existing guideline and incorporate new research. A secondary objective was to provide an update related to the cost-effectiveness of diagnostic procedures, therapeutic interventions and prevention strategies. It was posited that subsequent interaction of clinicians with this guideline could help reduce health impairments and patient burden associated with this prevalent musculoskeletal injury. The previous guideline provided evidence that the severity of ligament damage can be assessed most reliably by delayed physical examination (4–5 days post trauma). After correct diagnosis, it can be stated that even though a short time of immobilisation may be helpful in relieving pain and swelling, the patient with an acute lateral ankle ligament rupture benefits most from use of tape or a brace in combination with an exercise programme.New in this update: Participation in certain sports is associated with a heightened risk of sustaining a lateral ankle sprain. Care should be taken with non-steroidal anti-inflammatory drugs (NSAIDs) usage after an ankle sprain. They may be used to reduce pain and swelling, but usage is not without complications and NSAIDs may suppress the natural healing process. Concerning treatment, supervised exercise-based programmes preferred over passive modalities as it stimulates the recovery of functional joint stability. Surgery should be reserved for cases that do not respond to thorough and comprehensive exercise-based treatment. For the prevention of recurrent lateral ankle sprains, ankle braces should be considered as an efficacious option.

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Section: Resultsmentioning

confidence: 99%

Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline

et al. 2018

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“…The included studies (n = 5) were published between 2005 and 2015. Two studies [ 29 , 30 ] were conducted in the USA, one [ 15 ] in the UK, one [ 32 ] in South Korea and one [ 31 ] in Iran. All studies were small with 25–161 participants recruited.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies [ 30 , 31 , 32 ] were parallel group RCTs. Chibnall et al [ 29 ] was a cross-over RCT.…”

Section: Resultsmentioning

confidence: 99%

“…Interventions varied. Three studies considered analgesia [ 29 , 30 , 31 ], one a phosphodiesterase inhibitor (udenafil) [ 32 ] and one a practice manual [ 15 ] ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Morad et al [ 30 ] assessed analgesic administration records following each pain assessment. Hajimaghsoudi et al [ 31 ] assessed the adherence to the dosing schedule based on the number of returned tablets.…”

Section: Resultsmentioning

confidence: 99%

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

2018

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PRN is the acronym for ‘pro re nata,’ written against prescriptions whose administration should be based on patients’ needs, rather than at set times. The aim of this systematic review was to explore safety issues and adverse events arising from PRN prescription and administration. Electronic databases including Scopus, PubMed [including Medline], Embase, Cinahl, Web of Science and ProQuest were systematically searched to retrieve articles published from 2005 to 2017. Selection criteria: we included all randomized controlled trials (RCTs) and studies with comparison groups, comparing PRN prescription and 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 inclusion criteria 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 one exception, a pre-test post-test experimental design. Patient populations, interventions and outcomes varied. Studies compared patient-controlled or routine administration with PRN and one trial assessed the effect of a practice guideline on implementation of PRN administration. More analgesia was administered in the patient-controlled than the PRN arms but pain reduction was similar. However, there was little difference in administration of psychotropic medicines. No differences between patient-controlled and PRN groups were reported for adverse events. The PRN practice guideline improved PRN patient education but non-documentation of PRN administration increased. This systematic review suggests that PRN safety issues and adverse events are an under-researched area of healthcare practice. Variations in the interventions, outcomes and clinical areas make it difficult to judge the overall quality of the evidence. Well-designed RCTs are needed to identify any safety issues and adverse events associated with PRN administration.

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The effect of oral anti-inflammatory drugs on reducing tooth sensitivity due to in-office dental bleaching

Almassri¹,

Zhang²,

Yang³

et al. 2019

The Journal of the American Dental Association

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Naproxen Twice Daily Versus as Needed (PRN) Dosing: Efficacy and Tolerability for Treatment of Acute Ankle Sprain, a Randomized Clinical Trial

Cited by 5 publications

References 14 publications

Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline

Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline

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

The effect of oral anti-inflammatory drugs on reducing tooth sensitivity due to in-office dental bleaching

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