Trends and practices in prescribing anti-psychotropic medications in hospitalized patients with psychiatric disorders in a secondary care hospital
Keywords:Prescribing pattern, Psychotropic medications, Inpatients, Psychiatric disorders
Background: Advances in the psycho-pharmacotherapy enhance the development of newer and better drugs in the management of psychiatric disorders. However, their proper utilization, safety and efficacy and adverse effects in the clinical practice needs continuous study. The study aimed to assess the trends and practice of prescribing psychotropic medications in hospitalized patients in a secondary care hospital in Ras Al Khaimah.
Methods: A prospective observational study was carried out for a period of six months in a psychiatry department. All the patient details including the demographic data and prescribing pattern of antipsychotic medication were collected from the patient case records and were later analysed by using descriptive statistics.
Results: A total of 50 patient’s prescription were analysed during the study period. Male (54%) predominance was noted over females (46%) with majority (64%) of patients were in the age group of 21-40 years. Schizophrenia (35.8%) was the most common psychiatric disorders followed by affective disorders (30.86%). The average number of psychiatric drugs per prescription was found to be 3.38±1.23. Antipsychotics (43.36%) were the commonly prescribed class of medications followed by mood stabilizers (12.38%) and anxiolytics (11.06%) with olanzapine (n=26), sodium valproate (n=21) and clonazepam (n=9) being frequently prescribed medications. Escitalopram (n=9) was the most commonly used anti-depressants. Combination therapy (86%) is preferred over monotherapy (14%).
Conclusions: This study helps to assist in ensuring rational drug therapy and reducing the incidence of drug related problems and medication errors and thereby enhancing the quality of care in patients with psychiatric disorders.
Swamy MK, Wagle L, Giri V. Drug utilization pattern of psychotropic drugs in psychiatric outpatient department of rural tertiary care teaching hospital. Int J Pharmaceut Sci Res. 2016;7(8):3497-3508.
Overview of the global situation. Mental Health Action Plan 2013- 2020. Available at: https://apps.who.int/iris/bitstream/handle/10665/89966/9789241506021_eng.pdf?sequence=1&isAllowed=y. Accessed on 08 August 2020.
Mental health. Available at: https://www.who.int/health-topics/mental-health#tab=tab1. Accessed on 11 August 2020.
World Health Organization. Mental Health. A call for action by World Health Ministers. Available at: http://www9.who.int/mental_health/media/en/249.pdf. Accessed on 12 August 2020.
Richardson TE, O'Reilly CL, Chen TF. Drug-related problems and the clinical role of pharmacists in inpatient mental health: an insight into practice in Australia. Int J Clin Pharm. 2014;36(5):1077-86.
Sarkar P, Chakraborty K, Misra A, Shukla R, Swain SP. Pattern of psychotropic prescription in a tertiary care center: A critical analysis. Ind J Pharmacol. 2013;45(3):270-3.
Mann E, Haastert B, Böhmdorfer B, Frühwald T, Iglseder B, Roller-Wirnsberger R et al. Prevalence and associations of potentially inappropriate prescriptions in Austrian nursing home residents: secondary analysis of a cross-sectional study. Wien Klin Wochenschr. 2013;125:180-88.
Hussain F, Alam M, Mali B, Akter H, Arafat SMY. Pattern of psychotropic prescription in a tertiary care hospital of Bangladesh: a cross-sectional analysis of prescription photos. Ment Health Addict Res. 2018;3(2):1-3.
Alam MT, Maruf MM, Sarkar M, Ahmed HU, Akhter M. Pattern of prescribing psychotropics in the outpatient department of a tertiary psychiatric hospital. Bang J Psychiatry. 2015;29(1):10-3.
Perumal VM, Boudhh SK, Nirmal SR, Deshpande A, Singh J, Prabhu NM. Drug utilization study and prescribing patterns in psychiatry patients at a tertiary care hospital. Int J Basic Clin Pharmacol. 2018;7(4):774-7.
Ubedulla SSID, Niloofar V. Drug Utilization study of psychotropic drugs in psychiatry out-patient department of a tertiary care hospital in Kerala: a geriatric perspective. Int J Basic Clin Pharmacol. 2019;8(8):1788-92.
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.
Chawla S, Agarwal M, Sharma S, Jiloha RC. Drug Utilization Study of Psychotropic Drugs among Psychiatric Outpatients in a Tertiary Care Hospital. Indian J Pharm Sci. 2017;79(6):1008-13.
Sushma HK, Jyothi CH, Somashekar HS, Avanthi E, Imran M, Raja B. Prescribing pattern of antipsychotic medications in patients with schizophrenia in a tertiary care hospital. Int J Basic Clin Pharmacol. 2015;4(1):134-8.
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):435-7.
Kumar S, Chawla S, Bimba HV, Rana P, Dutta S, Kumar S. Analysis of Prescribing Pattern and Techniques of Switching Over of Antipsychotics in Outpatients of a Tertiary Care Hospital in Delhi: A Prospective, Observational Study. J Basic Clin Pharma. 2017;8:178-84.
Siddhartha G, Swati B, Kumar DC. Antipsychotic prescribing pattern in a tertiary care hospital of Eastern India. J Drug delivery Therap. 2013;3(4):38-42.
Mohamed MMA, Yousef BA. Prescription patterns of antipsychotics in the management of first episode psychosis at three psychiatric hospitals in Khartoum, 2018: A descriptive cross-sectional study. J Family Med Prim Care. 2020;9(1):402-6.
Grover S, Nebhinani N, Chakrabarti S, Avasthi A, Mattoo SK, Basu D et al. Evaluation of psychotropic prescription patterns at the time of discharge from inpatient unit of a tertiary care general hospital psychiatric unit. J Mental Health Hum Behav. 2016;21:48-54.
Nukala S, Komaram RB, Singisetti S. A study on prescribing pattern of antipsychotics in Schizophrenia at a tertiary care hospital. IJPSR. 2019;10(5):2628-32.
Jena M, Mishra S, Mishra SN, Mishra SS. Psychotropic drugs: Prescribing pattern in psychiatry outpatient department of a tertiary care teaching hospital. Int J Pharm. 2014;4(4):204-8.
Sabu L, Yacob M, Mamatha K, Singh H. Drug utilization pattern of psychotropic drugs in psychiatry outpatient department in a tertiary care teaching hospital. Asian J Pharm clin Res. 2017;10(1):259-61.
Mukherjee S, Sen S, Chatterjee S, Biswas A, Sinha S, Ghosal et al. Prescribing Pattern of Psychotropic Medications in Psychiatry Outpatients at a Tertiary Care Teaching Hospital in India: A Prospective Cross-sectional Study. Int J Hospital Res. 2014;3(3):113-22.
Rode SB, Ajagallay RK, Salankar HV, Sinha U. A study on drug prescribing pattern in psychiatry put-patient department from a tertiary care etaching hospital. Int J Basic Clin Pharmacol. 2014;3(3):517-22.
Mogali SM, Kotinatot BC. Drug utilization study of antipsychotics among schizophrenia patients in a tertiary care teaching hospital: a retrospective observational study. Int J Basic Clin Pharmacol. 2020;9(6):971-4.
Siddiqui RA, Shende TR, Mahajan HM, Borkar A. Antipsychotic medication prescribing trends in a tertiary care hospital. Int J Basic Clin Pharmacol. 2017;5(4):1417-20.
Chuki P, Khanapure A, De Sousa A. A study on prescribing patterns of atypical antipsychotics in psychiatric disorders. Int J Pharma Res Health Sci. 2014;2(4):302-6.
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.