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Recent scenario on psychotropic drug usage pattern among patients attending psychiatric outpatient department of a tertiary care teaching hospital in Nepal

Vijay Raj Kaul, Mirza Atif Beg, Shaktibala Dutta, Shalu Bawa, Nand Kishore Singh, Sri Hari Dutta.

Abstract
Background: Due to increasing burden of psychiatric illnesses, it is essential to study the psychotropic drug utilization pattern in actual clinical practice. The objective of the study was to study the psychotropic drug usage pattern among patients attending psychiatric OPD of a tertiary care teaching hospital in Nepal.
Methods: This observational retrospective study was conducted in Nepal Gunj Medical College, Nepal for a period of 6 months from January 2016 to June 2016. A total of 282 prescriptions from Psychiatric OPD were analysed for drug usage pattern. Prescriptions containing at least one psychotropic drug were included. Data was measured for number and percentage of prescriptions or drugs, using selected World Health Organization (WHO) drug use indicators.
Results: A total of 282 prescriptions from Psychiatric OPD were analysed. Patients had a mean age of 35.01±1.17 years. Male and Female %age was 41.49% and 58.51% respectively. Majority of the patients (47.52%) were in 31-45 years age group. 70.57% patients were literate. Depression was the leading psychiatric illness seen in 144 (51.06%) patients followed by Anxiety disorders which were seen in 60 (21.28%) patients. A total of 2463 drugs were prescribed which included 591 (23.99%) antipsychotic drugs followed by 462 (18.76%) antidepressants, 390 (15.83%) antiepileptics, 312 (12.67%) supplements, 276 (11.21%) antianxiety, 171 (6.94%) antacids, 165 (6.7%) anticholinergics, 96 (3.9%) drugs in miscellaneous category. Drugs prescribed per prescription were 8.73 and psychotropic drugs per prescription were 6.09. Number of oral and injectable drugs were 2313 (93.91%) and 150 (6.09%) respectively. 87 fixed dose combinations (FDCs) of psychotropic drugs were prescribed. 903 (36.66%) drugs were prescribed from WHO’s 18th List of Essential Medicines.
Conclusions: Depression was the most common psychiatric illness and antipsychotics were the most commonly prescribed medicines in psychiatry OPD. Majority of the prescriptions revealed polypharmacy.

Key words: Drug utilization pattern, Psychotropic drugs, Polypharmacy, WHO drug use indicators


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