Predictors of controlled prescription drug non-medical and lifetime use among patients accessing public mental health services in Uganda: a cross-sectional study (original) (raw)
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Archives of Pharmacy Practice, 2013
Background: Drug utilization research facilitates the rational use of drugs and suggests measures to improve prescribing habits. Irrational use of drugs is a global problem affecting patient care. It results in increased mortality, morbidity, adverse drug events, and wastage of economic resources. Objectives: To evaluate the pattern of drug utilization at a regional neuropsychiatric hospital, in Benin City, Nigeria using some of the World Health Organization (WHO) prescribing indicators. Materials and Methods: Data was obtained retrospectively from a review of 5400 outpatient prescriptions between September 2007 and August 2012. Data were analyzed using the WHO guideline for assessment of drug use in health facilities. The number of DDD per one thousand inhabitants per day was calculated from data on the number and size of dispensed drugs obtained from the out-patient pharmacy. Drug Utilization 90% (DU 90%) method was used to evaluate the quality of drug prescribing. Results: An average of 2.88 drugs was prescribed per encounter, 94.38% of the drugs were prescribed using their generic names, and the percentage of encounters with antibiotics prescribed was 3.2% while 99.2% of all the drugs prescribed were prescribed from the essential drugs list. The drugs whose utilization accounted for about 90% of the entire drug use (DU 90%) were; haloperidol (15.5%), amitriptyline (22.3%), benzhexol (12.6%), trifluoperazine (20.3%), chlorpromazine (15.2%), and carbamazepine (7.9%). Haloperidol was the most utilized drug in this setting with a DDD per 1000 inhabitants per day of 5. In about 70% of the prescriptions encountered, all the drugs prescribed were available from the hospital pharmacy. Conclusion: This study found that polypharmacy was commonly practiced while haloperidol was the most utilized psychotropic agent at the study facility.
2014
Substance abuse refers to the overindulgence in and dependence of a drug or other chemical leading to effects that are detrimental to the individual’s physical and mental health or the welfare of the others. The study was to establish the prevalence of substance abuse among psychiatry patients and the common co-morbid psychiatric disorders at the Moi Teaching and Referral Hospital (MTRH) in Eldoret. This was a descriptive crosssectional study involving in-patients (30) and out -patients (45) who consented to participating in the study using the WHO model core questionnaire to collect information on use of various drugs among psychiatry patients. Most of the respondents who reported abusing any form of substance had begun before the age of 19 years. The most commonly abused substance was alcohol at 56% with more males (thirty one-41.7%) than females (Eleven14.7%).Others included cigarette 19(25.3%) and cannabis (locally known as bhang) among others. Substance abuse was significantly ...
Consumption of psychotropic medicines at a referral hospital Namibia: findings and implications
African Health Sciences
Setting: In Namibia, the burden of mental illnesses is estimated at 25.6% and is expected to double by 2025. Few studies in sub-Saharan Africa estimate the consumption rates of psychotropic medicines as a proxy of irrational use. Aim: The consumption rate of psychotropic medicines at a referral hospital was determined. Method: A hospital-based retrospective medicine utilization analysis of Facility Electronic Stock Card (FESC) psychotropic medication was conducted at Intermediate Hospital Katutura over a 7 year period, 2011-2017. Data on consumption and expenditure on psychotropic medicines were abstracted from FESC and analysed using descriptive statistics in SPSS v22. The main outcomes were consumption rates, daily Defined Dose, (DDD) and/or expenditure. Results: Of the 580 351,4 DDD of psychotropic medicines consumed, 84% were anti-psychotics, 9.2% anti-depressants and 6.8% anxiolytics. Anti-psychotics (48.8%) and anxiolytics (47.9%) had the highest consumption by cost relative t...
2021
Drug abuse constitutes a global health and social problems and cut across socioeconomic, cultural, religious and ethnic boundaries with conditions and problems that vary locally. Many communities are affected by drug abuse directly or indirectly. While the right use of drug is paramount to health, its abuse brings about detrimental effects. The pattern of drug abuse varies from a region to another. The knowledge of the prevalence of drug abuse and establishing the pattern peculiar to a region will help alleviate its burden on the society. The study was carried out among patients attending psychiatric clinic in Federal Medical Centre, Makurdi, Benue State to determine the prevalence of drug abuse in the population. A cross-sectional retrospective study in which a structured proforma was used to extract the socio-demographic, clinical and drug-related data from the medical folders of 127 patients that attended the clinic. Data analysis was done with statistical package for social scie...
Evaluation of psychotropic drugs utilization in a Nigerian psychiatric hospital 1 2
2016
Background: Information on drug utilization studies in psychiatry is rare in Nigeria and could be used in the evaluation of healthcare delivery systems. There is need to monitor drug use practices especially in psychiatry to help improve prescribing habits and consequences on the population. Objectives: To determine the prescribing pattern and assess the health facility indicators in a tertiary mental health facility in Lagos, Nigeria. Method: A prospective cross sectional study involving the use of six hundred prescriptions selected through systematic random sampling was carried out in the outpatient unit of the Federal Neuropsychiatric Hospital, Yaba (FNPHY), Lagos from August to December 2013. The prescribing pattern and health facility indicators were measured. Use of psychotropic drugs and the incidence of psychiatric disorders were also assessed. Results: Of the 600 prescription, 336 (56%) belonged to female patients while 264 (44%) belonged to male patients. Average number of...
Drug, Healthcare and Patient Safety
Rational drug use (RDU) promotes safe, efficient, and cost-effective utilization of medicines in hospital settings. The aim of this study was to assess rational drug use based on the World Health Organization (WHO) and the International Network for Rational Use of Drugs (INRUD) core drug use indicators. Patients and Methods: This prospective, descriptive, hospital-based cross-sectional study was conducted among patients attending the Outpatient Department of a secondary care hospital located in the Sheema District of Western Uganda. A total of 450 prescriptions were prospectively collected from eligible patients and subjected to evaluation by using the WHO/INRUD core drug use indicators (prescribing, patient care, and health-facility indicators). Results: The average number of drugs prescribed per encounter was found to be 3.2 (optimal value=1.6-1.8). The percentages of drugs prescribed by their generic name (90.48%) and from the Essential Medicine List (96.23%) were close to the WHO reference (100%). The percentage of antibiotics (66.22%) and injections (25.22%) per encounter exceeded the WHO standards (antibiotics=-20.0-26.8; injections=13.4-24.1). Among the patient-care indicators, the average consultation time (5.41 minutes), average dispensing time (131.03 seconds), percentage of medicines dispensed (76.11%), percentage of medicines adequately labeled (59.74%), and percentage of patients with dosage knowledge (49.50%) did not meet the WHO reference. Facility indicators such as the percentage of key medicines available in the stock (66.67%) did not conform to the WHO optimal value. The hospital made the EML hundred percent available to all practitioners. Conclusion: The study concludes that the prescribing, patient care, and health facility indicators at Sheema District Secondary Care Hospital deviate from the optimal values recommended by the WHO. Therefore, this study indicates a need for improvement on these indicators and a requirement for the ongoing educational initiatives focused on rational drug prescribing, dispensing, and patient use in order to comply with the standards set by the WHO.
Journal of Clinical Psychopharmacology, 2014
The study describes prescription patterns of psychotropic medications for patients treated for psychosis in psychiatric hospitals of Uganda. A cross-sectional quantitative survey of age, sex, diagnoses, and psychotropic medication of 682 psychiatric inpatients of the 2 national referral hospitals in Uganda was conducted on 1 day in March 2012. The percentage of patients treated with the same substance within the diagnostic categories schizophrenia, bipolar affective disorder, unspecified psychosis, and depressive disorder was calculated. Close to 90% of the patients with conditions diagnosed with any psychotic disorder were treated with first-generation antipsychotic drugs (eg, chlorpromazine, haloperidol, trifluoperazine, and depot fluphenazine). Carbamazepine in combination with first-generation antipsychotics was prescribed frequently (45%) for the treatment of bipolar affective disorder. The use of second-generation antipsychotics, lithium, and valproic acid was exceptional. Patients with depression usually received a combination (63%) of first-generation antipsychotics and antidepressants (fluoxetine or amitriptyline). Benzodiazepines were only infrequently used for patients diagnosed with psychoses. First-generation antipsychotics, antidepressants, and carbamazepine were the most frequently used medications for treatment of psychosis in Uganda. Although lithium and valproic acid were on the essential drug list in Uganda, their use was still infrequent. There is a need to ensure the practical availability of the drugs listed on the essential drug list and to support the implementation of their use in clinical practice.
The African Journal of Pharmacology and Therapeutics, 2017
Background: Substance use disorder is a complex chronic disease that requires a multidisciplinary approach in treatment. Pharmacotherapy is one of the components in the treatment of this condition. This study sought to assess the accessibility of medicines used in the treatment of substance use disorders in both a public and a private health facility in Nairobi. Methodology: This descriptive cross-sectional study with both qualitative and quantitative components was carried out in April and May 2015 at two hospitals in Nairobi, Mathare Mental Hospital (public) and Chiromo Lane Medical Centre (private). Data on availability and affordability was collected from the two sites and the WHO performance indicators for health facilities used to assess availability. Affordability was determined using the daily wage of the lowest paid government worker. Interviews with the key informants were conducted to determine factors that influence the accessibility of the medicines. Results: About 50%...