Prescription Patterns of Psychotropic Drugs and Non-Adherence in Patients with Schizophrenia
Journal Title: Journal of Medical Science And clinical Research - Year 2016, Vol 4, Issue 12
Abstract
Context - Polypharmacy, rational or irrational, in psychiatry is a common phenomenon. One needs to understand various clinical and pharmaco-socio-economic factors associated to deal with it. Non adherence to treatment in schizophrenia leads to relapse, hospitalizations, increased cost of treatment and therapeutic failure. Complexity of treatment decreases adherence. It is important to understand relation between polypharmacy and adherence. Aims and objectives - To find out prevalence of polypharmacy, most common causes of polypharmacy, level of medication adherence and correlation between polypharmacy and medication adherence in patients with schizophrenia Settings and Methodology - A total of 277 consecutive diagnosed patients with schizophrenia were included in the study. Their latest prescriptions were studied to find out rate of polypharmacy and most common reasons for doing so. Patients were asked to answer Morisky 8-item medication adherence scale, a valid and reliable measure of self reported adherence. Obtained data was analyzed statistically. Statistical analysis and Results - About 74 % of the patients received polypharmacy vs. 26 % received monotherapy. Three most common reasons for polypharmacy were to prevent adverse effects, to treat comorbidity and for augmentation. Polypharmacy did not have any association with age, sex, but polypharmacy had significant association with duration of illness. 36.5 % had low adherence, 21.7 % had high adherence while 41.9 % had medium adherence to prescribed regimen. Adherence did not show statistically significant association with age and sex but had significant association with total number drugs prescribed and duration of illness but failed to show any particular pattern. Conclusions - Polypharmacy is common practice in patients with schizophrenia at our centre and most common reason for it was to prevent adverse effects of primary drug, which is a justified indication. Adherence is a complex phenomenon, not related to factors such as age, sex but had association with duration of illness and total number of drugs prescribed. Most of our patients had medium adherence on MMAS. Polypharmacy did not have any significant effect on adherence across all age groups. Multiple complex factors influence polypharmacy and adherence in patients with schizophrenia like psycho-education, illness related factors and patient related factors. Probably rational polypharmacy is need of time.
Authors and Affiliations
Ashish H. Chepure
Keywords
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