Trends in the prescribing of antipsychotic medicines in Pakistan: implications for the future (original) (raw)
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Changing trends in anti-psychotic prescription pattern in Pakistan
Pakistan Journal of Medical Sciences, 2019
Background and Objective: This study was designed to identify the changing trends in Antipsychotic prescription pattern in Pakistan. It was part of the research project Research on East Asian Psychotropic Prescription Pattern (REAP) carried out to identify the prescription patterns of schizophrenic patients in different countries located in Asia. Our objective was to assess the trend and change of psychotropic drug prescriptions for patients with schizophrenia. Methods: The design of the study was quantitative and of descriptive epidemiology. This study was carried out from 30th March 2017. Data was collected on a unified protocol by the Psychiatrists from Pakistan. Three (3) centers i.e., Lahore, Karachi and Islamabad provided the data. Indoor and outdoor cases with Schizophrenia were recruited. A web based recording system for collection of data done at Taipei Taiwan, and statistical analysis was performed and transferred to all participating centers including Pakistan. Results: T...
Prescription Pattern and Off-Label Use of Antipsychotics in a Middle Eastern Population
Frontiers in Pharmacology, 2021
Background: Understanding the prescription pattern of medications in a population can help reveal the potential usage scenarios, including off-label prescriptions, and the need for precision medicine implementation. Therefore, the aim of this study was to assess the prescription pattern and off-label use of antipsychotics in the Qatari population.Methods: We performed a cross-sectional study of Qatari patients who received antipsychotic prescriptions from the major healthcare providers in the country during the 2-year period between June 2018 and May 2020. The number of patients, prescriptions dispensed, and clinical indications were collected and statistical analysis using chi-square test was conducted.Results: Among the 9,349 Qatari patients prescribed with antipsychotics during the study period, the majority were female (57%; p < 0.001) and were in the age categories 20–39 and 30–39 years (both 22%; p < 0.001). Among the 35,938 antipsychotic prescriptions dispensed, second-...
International trends in antipsychotic use: A study in 16 countries, 2005-2014
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, 2017
The objective of this study was to assess international trends in antipsychotic use, using a standardised methodology. A repeated cross-sectional design was applied to data extracts from the years 2005 to 2014 from 16 countries worldwide. During the study period, the overall prevalence of antipsychotic use increased in 10 of the 16 studied countries. In 2014, the overall prevalence of antipsychotic use was highest in Taiwan (78.2/1000 persons), and lowest in Colombia (3.2/1000). In children and adolescents (0-19 years), antipsychotic use ranged from 0.5/1000 (Lithuania) to 30.8/1000 (Taiwan). In adults (20-64 years), the range was 2.8/1000 (Colombia) to 78.9/1000 (publicly insured US population), and in older adults (65+ years), antipsychotic use ranged from 19.0/1000 (Colombia) to 149.0/1000 (Taiwan). Atypical antipsychotic use increased in all populations (range of atypical/typical ratio: 0.7 (Taiwan) to 6.1 (New Zealand, Australia)). Quetiapine, risperidone, and olanzapine were m...
2020
BACKGROUND Antipsychotic medications are the first-line pharmacological intervention for severe mental illnesses(SMI) such as schizophrenia and other psychoses, while also being used to relieve distress and treat neuropsychiatric symptoms in dementia. Since 2014 many antipsychotic agents have moved to generic provision. In 2017_18 supplies of certain generic agents were affected by substantial price increases. Our aim was to examine factors relating to antipsychotic prescribing in general practices across England and how cost changes in recent years have impacted. METHODS The study examined over time the prescribing volume/prices paid for antipsychotic medication by agent in primary care. The NHS in England/Wales publishes each month the prescribing in general practice by BNF code. This was aggregated for the year 2018_19 using Defined Daily doses (DDD). Cost of each agent year-on-year was determined. Monthly prescribing in primary care was consolidated over 5 years(2013-2018) and D...
Pharmacoepidemiology and drug safety, 2017
Antipsychotic-prescribing patterns remain unclear in Asia. The aims of our study were to investigate prescribing trends of antipsychotic medication in the general population, children, and older patients by drug generation (first or second), the prescribing trend in pregnant women, the probable indication for antipsychotic prescription, and the prescribing trend by dosage form. This descriptive study identified and included all patients prescribed with antipsychotic in Hong Kong from 2004 to 2014 using the Clinical Data Analysis and Report System. This study calculated and reported the prevalence of antipsychotic prescribing in patient groups of interest, the percentage with diagnoses of mental disorders were derived, and the prevalence of antipsychotic by dosage forms. The study included 10 109 206 prescriptions of any antipsychotics to 256 903 patients. Over the study period, the prevalence of antipsychotic prescribing increased from 1.06% to 1.54% in the general population, from ...
Neuropsychiatric Disease and Treatment, 2016
Objective: To study the pattern of psychotropic medication use and compare this pattern between inpatient and outpatient psychiatric settings in Saudi Arabia. Method: This cross-sectional observational study was conducted between July 2012 and June 2014 on patients seeking psychiatric advice at major hospitals in five main regions of Saudi Arabia. Male (n=651) and female (n=594) patients who signed the informed consent form and were currently or had been previously using psychotropic medications, irrespective of the patient's type of psychiatric diagnosis and duration of the disease, were included. A total of 1,246 patients were found to be suitable in the inclusion criteria of whom 464 were inpatients while 782 were outpatients. Results: Several studied demographic factors have shown that compared with outpatients, inpatients were more likely to be male (P=0.004), unmarried (P,0.001), have less number of children (1-3; P=0.002), unemployed (P=0.001), have a lower family income (,3,000 SR; P,0.001), live in rural communities (P,0.001), have a lower body mass index (P=0.001), and are smokers (P,0.001); however, there were no differences with regard to age or educational levels. The current frequency of use of psychotropic medications in overall patients was antipsychotics (76.6%), antidepressants (41.4%), mood stabilizers (27.9%), and antianxiety (6.2%). However, compared to outpatients, the current use of medications for inpatients was more frequent (93.8% vs 89.9%, P=0.019) with inpatients more likely to be treated with multiple medications (2.1 vs 1.8 medications). A similar trend was observed in the case of antipsychotics, high potency first-generation antipsychotics, second-generation antipsychotics, mood stabilizers, and antianxiety medicines where inpatients were more frequently treated with these medications for all psychiatric diagnoses when compared with outpatients. On the contrary, in the case of antidepressant treatment, an opposite trend was observed with more number of treated outpatients in comparison to inpatients. Among elderly patients, 75.9% received antipsychotics, mainly second-generation formulations (67.2%), whereas only 41% received antidepressants and 13.8% received mood stabilizers. Conclusion: Based upon the present study data, it is concluded that among all the psychotropic medications, antipsychotics were heavily used and the frequency was found to be significantly high in the case of inpatients compared with outpatients. Such a practice may lead to multiple negative consequences among the Saudi psychiatric patient population. Further, extensive use of sodium valproate in the case of bipolar disorder, and also among females either in childbearing age or during pregnancy is also the cause of concern and warrants logical use. Overall, this study may help in assessing the burden of psychiatric illness within specific patient demographics and might be effectively used to strategically plan health resources allocation, generate new treatment hypothesis, or be used as a source of evidence that could further integrate other observational studies.
Typical and Atypical Antipsychotic Drug Utilization in a Psychiatric Clinic in Palestine
2004
Pattern of atypical and typical antipsychotic medications among one hundred and twenty four patients receiving these medications was investigated and analyzed. Males constitute approximately 61% of the sample. More than half of the patients in the sample were less than 50 years old. Most the patients prescribed antipsychotic medications were having schizophrenia (61%). Analysis of the prescribed antipsychotics for the
Objective: To determine which antipsychotics mental health professionals from a low income country would choose for themselves. Design: Cross-sectional study Place and duration of study: This study was conducted in 8 cities in Pakistan from February to August 2008. Subjects and Methods: Responses from 268 mental health professionals, including psychiatrists and nurses were obtained using a semi-structured questionnaire. Results: All together 80% of doctors chose an atypical antipsychotic; risperidone was the most popular choice. Half of nurses did not know which antipsychotic to choose and the remaining chose haloperidol (21%) and risperidone (19%). Efficacy and safety were the two most important factors influencing their decision. Conclusion: Both doctors and nurses in Pakistan considered efficacy and safety/tolerability to be important factors for choosing an antipsychotic; this is in line with National Institute of Clinical Excellence (NICE) guidelines 2009. Mental health trainin...
Typical and Atypical Antipsychotic Drug Utilization in a Psychiatric Clinic â in Palestine
2004
Pattern of atypical and typical antipsychotic medications among one hundred and twenty four patients receiving these medications was investigated and analyzed. Males constitute approximately 61% of the sample. More than half of the patients in the sample were less than 50 years old. Most the patients prescribed antipsychotic medications were having schizophrenia (61%). Analysis of the prescribed antipsychotics for the patients showed that approximately 99% of the patients were receiving conventional typical antipsychotic medications either as single (70.2%) or combination (17.7%) or in depot form (10.4%). Less than 2% of the patients were receiving atypical antipsychotic medications. Among those prescribed conventional typical antipsychotic drugs, only (56%) were co-prescribed anticholinergic drugs. The underutilization of atypical antipsychotics and the underutilization of anticholinergics to be co-prescribed with conventional antipsychotics require further evaluation and investigation at the national Palestinian level.
Pharmacology & Pharmacy, 2012
The aim of this study is to determine the antipsychotic prescribing pattern and the prevalence of concurrent anticholinergic prescribing in a psychiatric referral hospital. A retrospective audit of prescriptions issued for outpatients was carried out at the Psychiatric Hospital, the only facility that provides psychiatric services for both inpatients and outpatients in the Kingdom of Bahrain. Antipsychotic monotherapy was prescribed for 89.2% patients, whereas polytherapy with two-and three-drugs in 10.4% and 0.4%, respectively. Atypical antipsychotics were prescribed more often (67.7%) than typical antipsychotics. Risperidone and haloperidol were the most frequently prescribed antipsychotics. Long-acting risperidone injection was the only depot preparation prescribed. The mean antipsychotic dose expressed as chlorpromazine equivalent (CPZeq; mg/day) was 242 (220 for monotherapy and 414 for polytherapy). The prevalence of high dose antipsychotic (mean CPZeq > 1000 mg/day) was 1.8%, prescribed at a mean CPZeq dose of 1531 (1925 for monotherapy and 1137 for polytherapy), mainly attributed to haloperidol. Anticholinergics were co-prescribed for almost two third of patients receiving antipsychotics, particularly for those on polytherapy (monotherapy 57.3%; polytherapy 87.5%). Antipsychotic polytherapy, high dose and co-prescription of an oral with a depot antipsychotic preparation were strongly associated with concurrent prescription of anticholinergics. Procyclidine and orphenadrine were the most often prescribed anticholinergics. In Bahrain, antipsychotic monotherapy is a common practice for outpatients with psychotic disorders. Some of the antipsychotic polytherapies, dosage strategies, and high prevalence of anticholinergic use are therapeutic issues that need to be addressed to foster evidence-based prescribing practice.