It is unclear why the use of chemical restraints was more common than that of physical restraints. One may speculate that the latter were seen as less humane or more likely to cause harmful side-effects. The majority of patients had both physical and chemical restraints applied. We suspect that physicians and nursing staff were simultaneously trying both types of restraints because they had little indication of which would work best. Combined use has not been previously studied.
Research is needed to assess the effectiveness of each type of restraint alone, and in combination.
We concur with the call for guidelines on the rational use of restraints. At the time of writing, Dr. Kow was with the Department of Internal Medicine, University of Calgary, Calgary, Alt. Dr. Hogan is with the Division of Geriatric Medicine, University of Calgary. Lever JA, Molloy DW, Eagle DJ, Butt G, Bedard M, Millar P, et al. Use of physical restraints and their relationship to medication use in patients in four different institutional settings.