Assessment of psychotropic medicines utilization pattern for mental disorders treatment in Hadiya Zone Public Hospitals, Southern Ethiopia: a crosssectional study
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Date
2020-08
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Addis Abeba University
Abstract
Mental disorders are becoming issue of public health priority globally and their prevalence is
increasing in recent times. Subsequently, psychotropic medicines are widely used for treatment
mental disorders. However, medicines utilization studies have revealed irrational psychotropic
medicines use is a serious problem worldwide and there is a dearth of information on
psychotropic medicines utilization pattern in developing countries including Ethiopia. This study
was conducted to assess psychotropic medicines utilization pattern in Hadiya Zone public
hospitals namely Hoomacho and Shone primary hospitals and Wachemo University Nigist Eleni
Memorial Teaching Hospital. Hospital based cross sectional study was conducted from June 15
2019 to December 30 2019. Medical charts were reviewed retrospectively using data abstraction
format and Patients’ interview and observational assessment were conducted prospectively using
questionnaires. Data were entered and analyzed using EPI stata version 3 and SPSS version 20.
Out of the 1200 psychiatry patients’ for whom their medical charts were reviewed, majority
655(54.6%) were males; and in age group of 15-29 years 760(63.3%); with mean age 29.5
(SD±15). Regarding diagnosis, majority of psychiatric cases were diagnosed with psychosis
330(27.50%) followed by schizophrenia 188(15.67%). From the total of 1734 prescribed
psychotropic medicines, most commonly prescribed medicines were antipsychotics 834(48.1%)
followed by antidepressants 446(25.7%%) anticonvulsants or mood stabilizers 288(16.6%). The
three most commonly prescribed antipsychotic medicines, chlorpromazine, haloperidol, and
thioridazine constituted 71.34% of antipsychotic utilized in Hadiya Zone Public hospitals.
Typical antipsychotics were prescribed more often 616(73.86%) than atypical antipsychotics
218(26.14%). Amitriptyline was the most frequently prescribed antidepressant 334(74.9%)
followed by Fluoxetine 98(21.8%). Treatment switch was undertaken for 148(12.33%) patients
and main reasons were poor control/improvement 46(33.1%), relapse 29(20.9%) and side effect
22(15.8%). Average number of psychotropic medicines per encounter was 1.5. However, the
percentage of clients prescribed two or more psychotropic medicines was 36.1% that shows
polyphrmacy prescribing practice. The average consultation and dispensing time were 9.1
minutes and 51.87 seconds respectively. Frequency was labeled only on 60(19.5%) dispensed
medicines and 113(36.8%) patients had knowledge on doses of their medicines.
Conclusion and recommendation: Antipsychotics were most commonly utilized psychotropic
medicines followed by antidepressants and anticonvulsants. Chlorpromazine, Amitriptyline and
Risperidone showed higher proportion of utilized medicines. More than one-third psychiatric
patients were prescribed psychotropic polyphrmacy. Close to a tenth of psychiatric patients had
treatment switch. Average consultation and dispensing times was constrained. Most patients’
medications were dispensed without adequate labeling and patients’ knowledge about dispensed
medications were limited. Further, prospective continuous study on both prevalence and use
pattern need to be undertaken to get more information on psychotropic medicines utilization.
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Keywords
Mental disorders, psychotropic medicines, utilization pattern, antipsychotics and antidepressants