Psychotropic drug utilization in psychiatric outpatient department of a tertiary care government hospital
Keywords:Psychotropic drugs, Prescribing pattern, WHO indicators
Background: Mental disorders are associated with significant distress in social, occupational and other important activities. Of the ten health conditions contributing to the DALYs, four are psychiatric disorders. Psychiatric disorders form an important public health priority and major causes of morbidity. Psychotropic drugs had a remarkable impact in psychiatric practice. The utilization, clinical practice, effectiveness and safety in real life situation need continuous study.
Methods: A cross-sectional study was carried out by analyzing prescriptions of patients who visited the OPD of the psychiatry department of VIMSAR, Burla for a period of 4 months. Patients of all ages and both sexes were included in this study with exclusion of patients suffering from epilepsy and cases with uncertain diagnosis. The prescribing pattern was analyzed using WHO basic drug indicators.
Results: Average number of drugs per prescription was 3.17. Bipolar affective disorder (BPAD) was the most common psychiatric condition (44%) with a male predominance followed by schizophrenia. Olanzapine was the most common antipsychotic used. The most frequently used fixed dose combination was tri-hexiphenydyl and risperidone. Prescribing frequency of different psychotropic drugs (antipsychotics, antianxiety, selective serotonin reuptake inhibitors, tricyclic antidepressant, mood stabilizers) were compared.
Conclusions: The study advocated a rational use of psychotropic drugs with fewer deviations due to socio-economic status of patients and prescription practices of healthcare providers.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC; 2013.
Murthy R. Mental Health Programme in the 11th five years plan. Indian J Med Res. 2007;11:707-12.
Math SB, Chandrashekar CR, Bhugra D. Psychiatric epidemiology in India. Indian J Med Res. 2007;126(3):183-92.
Lee D, Bergmen U. Studies of utilization. In: Strom BC, editor. Pharmacoepidemiology. 1st ed. New York: Churchill Livingstone; 1989:259-73.
Hogerzeil HV. Promoting rational prescribing: an international perspective. Br J Clin Pharmacol. 1995;39:1-6.
Patterson HR. The problems of audit and research. J R Coll Gen Pract. 1986;36:196.
Tabish A, Sharma S, Sajid A. Drug utilisation research in psychiatry outdoor in tertiary care hospital, Bastar region. IJPR. 2015;5(4).
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.
Piparva KG, Parmar DM, Singh AP, Gajera MV, Trivedi HR. Drug utilization study of psychotropic drugs in outdoor patients in a teaching hospital.
Jorm A, Christensen H, Griffiths K. Changes in depression awareness and attitudes in Australia: the impact of beyondblue: the national depression initiative. Australian New Zealand J Psychiatry. 2006;40:42-6.
Goyal D, Munjal S, Gupta D. Drug Utilization Pattern of Psychotropic Drugs Prescribed in the Psychiatric Department of a Tertiary Care Government Hospital, Rajasthan. IOSR J Dental Med Sci. 2016;15(07):80-7.
Chandra S, Khan IN, Mateenudin M, Chandrakapure A, Maaz S, Mubin F. Drug utilization study in OPD of a tertiary care hospital in a rural area of Jalna, Maharashtra, India by using WHO prescribing indicators. Int J Basic Clin Pharmacol. 2018;7:55-8.
Ajapuje P, Dhengre P, Giri VC, Khakse GM. Drug Prescription Practices among Pediatric Patients in Yavatmal, Central India. Int J Recent Trends Sci Technology. 2012;5(2):104-6.
Bajait CS, Pimpalkhute SA, Sontakke SD, Jaiswal KM, Dawri AV. Prescribing pattern of medicine in chronic kidney disease with special emphasis on phosphate binders. IJP. 2014:46:35-9.
Mudhaliar MR, Ishrar SMG, Sadubugga P, Narala SR, Chinnakotla V, Yendluri P. Psychotropic drug utilization in psychiatric outpatient department of a teriary care teaching hospital in India. Int J Res Med Sci. 2017;5:1612-6.
Wheeler A. Atypical antipsychotic use for adult outpatients in New Zealand’s Auckland and Netherland regions. JNZ Med Assoc. 2006;119:1237.
Grover S, Avasthi A, Sinha V. Indian Psychiatric Society multicentric study: Prescription patterns of psychotropics in India. Indian J Psychiatry. 2014;56(3).
Ashton H. Guidelines for the rational use of Benzodiazepines. Drugs. 1994;48:25-40.
Rode SB, Ajagallay RK, Salankar HV. A study of drug prescribing pattern in psychiatry out-patient department of a tertiary care teaching hospital. Int J Basic Clin Pharmacol. 2014;3(3):517-22.
Serretti A, Ronchi D, Lorenzi C. New antipsychotics and schizophrenia: a review on efficacy and side effects. Curr Med Chem. 2004;11(3):343-58.
National Institute for Health and clinical Excellence. Schizophrenia: Core interventions in the treatment and management of schizophrenia in adults in primary and secondary care. Available at: http://www.nice.org.uk/ Accessed on 2 February 2009.
Jena M, Mishra S, Mishra SN. Psychotropic drugs prescription pattern in outdoor of tertiary care hospital. Int J Pharm. 2014;4(4):204-8.
Tran PV, Hamilton SH, Kuntz AJ. Double-blind comparison of olanzapine versus risperidone in the treatment of schizophrenia and other psychotic disorders. J Clin Psychopharma. 1997;17(5):407-18.
Avasthi A, Aggarwal M, Grover S. Research on antipsychotics in India. Indian J Psychiatry. 2010;52(1):317-40.