Study of prescription pattern in emergency psychiatry in a tertiary care academic hospital of a developing country: a retrospective study
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20160099Keywords:
Prescription pattern, Antipsychotics, Antidepressants, Mood stabilizers, Anxiolytics, Sedatives, Developing countryAbstract
Background: Prescription pattern study of psychotropic drugs gives a picture of drug preference and rationality of drug use by psychiatrists of a region. The aim of the study was to explore the prescription pattern of psychotropic drugs in emergency settings in a tertiary care centre in a developing country.
Methods: A total of 1153 prescriptions were analysed in the study. Data was extracted retrospectively from the psychiatry department emergency register of a tertiary care hospital, in north-eastern India for a period of one year.
Results: The most commonly used psychotropic drug in emergency setting was found to be anxiolytic and hypnotics (60.96%) in which clonazepam (48.6%) was commonest. Antipsychotics followed next (14.5%), out of which 69.6% were atypical antipsychotics with olanzapine being the commonest.
Conclusions: Use of parenteral typical antipsychotic was found to be much higher, than expected. For the benefit of the mass, supply of cost effective parenteral atypical antipsychotics is the need of the hour in this part of the world.
References
World Health Organization. Introduction to drug utilization research introduction to drug utilization research, 2003.
Jain S, Upadhyaya P, Goyal J, Kumar A, Jain P, Seth V, et al. A systematic review of prescription pattern monitoring studies and their effectiveness in promoting rational use of medicines. Perspect Clin Res. 2015;6(2):86-90.
Chee KY, Tripathi A, Avasthi A, Chong MY, Sim K, Yang SY, et al. International study on antidepressant prescription pattern at 40 major psychiatric institutions and hospitals in Asia: A 10-year comparison study. Asia Pac Psychiatry. 2015;7(4):366-74.
Uchida N, Chong MY, Tan CH, Nagai H, Tanaka M, Lee MS, et al. International study on antidepressant prescription pattern at 20 teaching hospitals and major psychiatric institutions in East Asia: Analysis of 1898 cases from China, Japan, Korea, Singapore and Taiwan. Psychiatry Clin Neurosci. 2007;61(5):522-8.
Lantz MS, Louis A, Lowenstein G, Kennedy GJ. A longitudinal study of psychotropic prescriptions in a teaching nursing home. Am J Psychiatry. 1990;147(12):1637-9.
Grover S, Kumar V, Avasthi A, Kulhara P. An audit of first prescription of new patients attending a psychiatry walk-in-clinic in north India. Indian J Pharmacol. 2012;44(3):319-25.
Ramadas S, Kuttichira P, Sumesh TP, Ummer SA. A study of an antipsychotic prescription pattern of patients with schizophrenia in a developing country. Indian J Psychol Med. 2010;32(1):13-6.
Rode S, Ajagallay R, Salankar H, Sinha U. A study on drug prescribing pattern in psychiatry out-patient department from a tertiary care teaching hospital. Int J Basic Clin Pharmacol. 2014;3(3):517.
Ghosh S, Bhattacharyya S, Dalai CK. Antipsychotic prescribing pattern in a tertiary care hospital of eastern india. J Drug Deliv Ther. 2013;3(4):38-42.
Paul PK, Konwar M, Das S. To study the prescribing pattern of antipsychotic drugs in a tertiary care hospital of assam. Int J Pharm Pharm Sci. 2014;6(4):4-6.
WHO. WHO Model Lists of Essential Medicines. http://www.who.int/medicines/publications/essentialmedicines/en/. Accessed November 11, 2015.
Gitanjali B, Manikandan S. National list of essential medicines of India: The way forward. J Postgrad Med. 2012;58(1):68. doi:10.4103/0022-3859.93258.
Ang AW, Ko SM, Kua EH. Psychiatric referrals from an accident and emergency department in Singapore. J Accid Emerg Med. 1995;12(2):119-22.
Kelkar DK, Chaturvedi SK, Malhotra S. A study of emergency psychiatric referrals in a teaching general hospital. Indian J Psychiatry. 1982;24(4):366-9.
Keertish N, Sathyanarayana MT, Kumar BGH, Singh N, Udagave K. Pattern of psychiatric referrals in a tertiary care teaching hospital in southern India. J Clin Diagn Res. 2013;7(8):1689-91.
Shahid M, Khan MZ, Ejaz K, Nakeer R, Iftikhar S. Profile of psychiatric patients presenting to a tertiary care emergency department of Karachi. J Coll Physicians Surg Pak. 2015;25(5):386-8.
Shakya DR, Shyangwa PM, Shakya R. Psychiatric emergencies in a tertiary care hospital. JNMA J Nepal Med Assoc. 2008;47(169):28-33.
Thakkar KB, Jain MM, Billa G, Joshi A, Khobragade AA. A drug utilization study of psychotropic drugs prescribed in the psychiatry outpatient department of a tertiary care hospital. J Clin Diagn Res. 2013;7(12):2759-64.
Sharma S, Chadda R, Rishi R, Gulati RK, Bapna J. Prescribing pattern and indicators for performance in a psychiatric practice. Int J Psychiatry Clin Pract. 2003;7(4):231-8.
Wheeler Vega JA, Mortimer AM, Tyson PJ. Conventional antipsychotic prescription in unipolar depression, I: an audit and recommendations for practice. J Clin Psychiatry. 2003;64(5):568-74.
Sarkar P, Chakraborty K, Misra A, Shukla R, Swain SP. Pattern of psychotropic prescription in a tertiary care center: a critical analysis. Indian J Pharmacol. 2013;45(3):270-3.
Ernst CL, Bird SA, Goldberg JF, Ghaemi SN. The prescription of psychotropic medications for patients discharged from a psychiatric emergency service. J Clin Psychiatry. 2006;67(5):720-6.
Grover S, Avasthi A, Sinha V, Lakdawala B, Bathla M, Sethi S, et al. Indian psychiatric society multicentric study: prescription patterns of psychotropics in India. Indian J Psych. 2014;56(3):253-64.
Folstein M, Folstein S, McHugh R. Mini-Mental State Examination (MMSE : A practical method for grading the cognative state of patients for the clinicians. J Psychiatr Res. 1975;12:189-98.
Banerjee I, Roy B, Sathian B, Banerjee I, Chakraborty PK, Saha A. Socio demographic profile and utilization pattern of antipsychotic drugs among schizophrenic inpatients: a cross sectional study from western region of Nepal. BMC Psychiatry. 2013;13:96.
Shiroma PR, Geda YE, Mohan A, Richardson J. Antidepressant prescription pattern in a hospice program. Am J Hosp Palliat Care. 2011;28(3):193-7.
Grover S, Avasthi A. Anti-psychotic prescription pattern: A preliminary survey of Psychiatrists in India. Indian J Psych. 2010;52(3):257-9.
Grover S, Avasth A, Kalita K, Dalal PK, Rao GP, Chadda RK, et al. IPS multicentric study: Antidepressant prescription patterns. Indian J Psych. 2013;55(1):41-5.
