Socio demographic profile and utilization pattern of antipsychotic drugs among schizophrenic inpatients: a cross sectional study from western region of Nepal

Abstract

BackgroundCurrently a large number of atypical antipsychotics available in the market are endorsed as better option for treating schizophrenia than the typical antipsychotics. Information regarding the utilization pattern of antipsychotic drugs is lacking in Nepalese population particularly in Western Nepal. By means of this study one is expected to acquire an idea concerning clinician’s preference to the antipsychotic drugs in actual clinical setup. The main objective of the study was to find the commonest antipsychotics prescribed in a tertiary care center among hospitalized patients in Western Nepal.MethodsThis cross sectional study was carried out between 1st January 2009 and 31th December 2010 at Manipal Teaching Hospital, Nepal. The diagnosis of schizophrenia was based on ICD-10 (Tenth revision).The main outcome variables of the study was commonest antipsychotic drug prescribed. Z test, Chi square test and logistic regression were used for analytical purpose. P-value < 0.05 was considered to be statistically significant. This is the first study done on the utilization pattern of antipsychotics drugs among hospitalized patients in Nepal.ResultsOut of 210 cases of schizophrenia, most of the patients were less than 40 yrs. 78.6%, male 61.9%, unemployed 86.7% and having their monthly income less than NPR 10000 /month 80.5%. As far as religion, 78.1% patients were the Hindus and ethnically schizophrenia was common among the Dalit 26.2%. The study revealed that 46.2% of patients were students followed by 25.2% of housewives. Olanzapine was the commonest antipsychotic drug to be prescribed 34.3%. It was observed that the psychiatrists had a tendency of using antipsychotic drugs by trade names [OR 3.3 (1.407, 8.031)] in male patients as compared to female patients.ConclusionAccording to the utilization pattern of antipsychotics, it is concluded that atypical antipsychotics were used relatively more commonly than that of typical antipsychotics. Among the atypical antipsychotic drugs, there is a trend of using Olanzapine during Schizophrenia as compared to other atypical antipsychotic drugs in Western Nepal.

Antipsychotics in schizophrenia: a retrospective study of drug utilization pattern in outpatient department of psychiatry at a tertiary care hospital

“…Our result was similar to the study conducted by Banerjee et.al where 58.76% of males and 41.24% of females suffered from schizophrenia. 8 Our results were also similar to a multicentric study, conducted by MY Chong et.al where male predominance was consistent accounting for 55.9% of cases. 9 Most of the schizophrenics were <40years (70%) and the average age was 35.6 years.…”

“…Similar results were seen with a study conducted by Banerjee et.al where 78.6% were <40years and 21.4% were >40years. 8 But different results were observed by the study conducted in Japan by S Cheung et.al, where the average age of patients suffering with schizophrenia was 61.9 years.…”

Psychotropic prescriptions for the treatment of schizophrenia in an outpatient clinic

“…8,9,20,21 About 70% of the patients were unemployed in this study. Some studies that determined the employment status of patients with schizophrenia who were on antipsychotics found that the majority of them were unemployed.…”

“…Some studies that determined the employment status of patients with schizophrenia who were on antipsychotics found that the majority of them were unemployed. 8,9 Employment rates among patients with schizophrenia are low, with an estimate from a European study ranging from 8 to 35%. 22 Individual factors (such as job histories), illness-related factors (such as illness severity) and societal conditions (such as discrimination and social welfare policy) are all potential contributors to variations in employment rates.…”

“…6,7 An unpredictable pattern has been observed in the prescription of antipsychotics and other psychotropic medications to patients with schizophrenia in clinical practice. In some parts of the world, there is a higher percentage of prescriptions of SGAs, [8][9][10] while in others,…”