Skip to main content
Top
Published in: BMC Psychiatry 1/2013

Open Access 01-12-2013 | Research article

Socio demographic profile and utilization pattern of antipsychotic drugs among schizophrenic inpatients: a cross sectional study from western region of Nepal

Authors: Indrajit Banerjee, Bedanta Roy, Brijesh Sathian, Indraneel Banerjee, Prasanta Kumar Chakraborty, Archana Saha

Published in: BMC Psychiatry | Issue 1/2013

Login to get access

Abstract

Background

Currently a large number of atypical antipsychotics available in the market are endorsed as better option for treating schizophrenia than the typical antipsychotics. Information regarding the utilization pattern of antipsychotic drugs is lacking in Nepalese population particularly in Western Nepal. By means of this study one is expected to acquire an idea concerning clinician’s preference to the antipsychotic drugs in actual clinical setup. The main objective of the study was to find the commonest antipsychotics prescribed in a tertiary care center among hospitalized patients in Western Nepal.

Methods

This cross sectional study was carried out between 1st January 2009 and 31th December 2010 at Manipal Teaching Hospital, Nepal. The diagnosis of schizophrenia was based on ICD-10 (Tenth revision).The main outcome variables of the study was commonest antipsychotic drug prescribed. Z test, Chi square test and logistic regression were used for analytical purpose. P-value < 0.05 was considered to be statistically significant. This is the first study done on the utilization pattern of antipsychotics drugs among hospitalized patients in Nepal.

Results

Out of 210 cases of schizophrenia, most of the patients were less than 40 yrs. 78.6%, male 61.9%, unemployed 86.7% and having their monthly income less than NPR 10000 /month 80.5%. As far as religion, 78.1% patients were the Hindus and ethnically schizophrenia was common among the Dalit 26.2%. The study revealed that 46.2% of patients were students followed by 25.2% of housewives. Olanzapine was the commonest antipsychotic drug to be prescribed 34.3%. It was observed that the psychiatrists had a tendency of using antipsychotic drugs by trade names [OR 3.3 (1.407, 8.031)] in male patients as compared to female patients.

Conclusion

According to the utilization pattern of antipsychotics, it is concluded that atypical antipsychotics were used relatively more commonly than that of typical antipsychotics. Among the atypical antipsychotic drugs, there is a trend of using Olanzapine during Schizophrenia as compared to other atypical antipsychotic drugs in Western Nepal.
Appendix
Available only for authorised users
Literature
1.
go back to reference Lee D, Bergmen U: Studies of utilization. Pharmacoepidemiology. Edited by: Strom BC. 1989, New York: Churchill Livingstone, 259-73. 1 Lee D, Bergmen U: Studies of utilization. Pharmacoepidemiology. Edited by: Strom BC. 1989, New York: Churchill Livingstone, 259-73. 1
2.
go back to reference Uppal R: Drug utilization studies: a brief overview. Annual update in clinical Pharmacology. 1993, 1: 54-55. Uppal R: Drug utilization studies: a brief overview. Annual update in clinical Pharmacology. 1993, 1: 54-55.
3.
5.
go back to reference Robin RW, Gottesman II, Albaugh B, Goldman D: Schizophrenia and psychotic symptoms in families of two American Indian tribes. BMC Psychiatry. 2007, 7: 30-10.1186/1471-244X-7-30.CrossRefPubMedPubMedCentral Robin RW, Gottesman II, Albaugh B, Goldman D: Schizophrenia and psychotic symptoms in families of two American Indian tribes. BMC Psychiatry. 2007, 7: 30-10.1186/1471-244X-7-30.CrossRefPubMedPubMedCentral
6.
go back to reference McGrath JJ, Susser ES: New directions in the epidemiology of schizophrenia. Med J Aust. 2009 Feb 16, 190 (4 Suppl): S7-9.PubMed McGrath JJ, Susser ES: New directions in the epidemiology of schizophrenia. Med J Aust. 2009 Feb 16, 190 (4 Suppl): S7-9.PubMed
7.
go back to reference McGrath J, Saha S, Chant D, Welham J: Schizophrenia: a concise overview of incidence, prevalence, and mortality. Epidemiol Rev. 2008, 30: 67-76. 10.1093/epirev/mxn001. Epub 2008 May 14.CrossRefPubMed McGrath J, Saha S, Chant D, Welham J: Schizophrenia: a concise overview of incidence, prevalence, and mortality. Epidemiol Rev. 2008, 30: 67-76. 10.1093/epirev/mxn001. Epub 2008 May 14.CrossRefPubMed
8.
go back to reference Jha A, Ranjan S, Pradhan PK, Jha T: Challenges of setting up psychiatric services in Nepal: Lessons from the first year of Janakpur Project. Asian J Psychiatr. 2011, 4 (4): 297-9. 10.1016/j.ajp.2011.10.004. Epub 2011 Dec 6CrossRefPubMed Jha A, Ranjan S, Pradhan PK, Jha T: Challenges of setting up psychiatric services in Nepal: Lessons from the first year of Janakpur Project. Asian J Psychiatr. 2011, 4 (4): 297-9. 10.1016/j.ajp.2011.10.004. Epub 2011 Dec 6CrossRefPubMed
9.
go back to reference Shrestha MR, Sherchan S, Shakya R, Joshi D: Monthly pattern of psychiatric morbidity and duration of stay among the patients admitted in Mental Hospital, a central level tertiary care hospital. Nepal Med Coll J. 2011 Jun, 13 (2): 133-6.PubMed Shrestha MR, Sherchan S, Shakya R, Joshi D: Monthly pattern of psychiatric morbidity and duration of stay among the patients admitted in Mental Hospital, a central level tertiary care hospital. Nepal Med Coll J. 2011 Jun, 13 (2): 133-6.PubMed
10.
go back to reference Tausig M, Subedi S, Subedi J, Ross J, Broughton LC, Singh R, Blangero J, Williams-Blangero S: Mental illness in Jiri Nepal. The Jirel issue. 2000, 27: 105-15. Jan Tausig M, Subedi S, Subedi J, Ross J, Broughton LC, Singh R, Blangero J, Williams-Blangero S: Mental illness in Jiri Nepal. The Jirel issue. 2000, 27: 105-15. Jan
11.
go back to reference Jablensky A, Sartorius N, Ernberg G, Anker M, Korten A, Cooper JE, Day R, Bertelsen A: Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychol Med Monogr Suppl. 1992, 20: 1-97.CrossRefPubMed Jablensky A, Sartorius N, Ernberg G, Anker M, Korten A, Cooper JE, Day R, Bertelsen A: Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychol Med Monogr Suppl. 1992, 20: 1-97.CrossRefPubMed
12.
go back to reference Hartling L, Abou-Setta AM, Dursun S, Mousavi SS, Pasichnyk D, Newton AS: Antipsychotics in adults with schizophrenia: comparative effectiveness of first-generation versus second-generation medications: a systematic review and meta-analysis. Ann Intern Med. 2012 Oct 2, 157 (7): 498-511. 10.7326/0003-4819-157-7-201210020-00525.CrossRefPubMed Hartling L, Abou-Setta AM, Dursun S, Mousavi SS, Pasichnyk D, Newton AS: Antipsychotics in adults with schizophrenia: comparative effectiveness of first-generation versus second-generation medications: a systematic review and meta-analysis. Ann Intern Med. 2012 Oct 2, 157 (7): 498-511. 10.7326/0003-4819-157-7-201210020-00525.CrossRefPubMed
13.
go back to reference Tamrakar SM, Nepal MK, Koirala NR, Sharma VD, Gurung CK, Adhikari SR: An open, randomized, comparative study of efficacy and safety of risperidone and haloperidol in schizophrenia. Kathmandu Univ Med J (KUMJ). 2006, 4 (2): 152-60. Tamrakar SM, Nepal MK, Koirala NR, Sharma VD, Gurung CK, Adhikari SR: An open, randomized, comparative study of efficacy and safety of risperidone and haloperidol in schizophrenia. Kathmandu Univ Med J (KUMJ). 2006, 4 (2): 152-60.
14.
go back to reference Shankar PR, Partha P, Shenoy N: Self-medication and non-doctor prescription practices in Pokhara valley. Western Nepal: a questionnaire-based study. BMC Fam Pract. 2002 Sep 17, 3: 17-PubMed Shankar PR, Partha P, Shenoy N: Self-medication and non-doctor prescription practices in Pokhara valley. Western Nepal: a questionnaire-based study. BMC Fam Pract. 2002 Sep 17, 3: 17-PubMed
17.
go back to reference World Health Organization: The ICD-10 Classification of mental and behavioral disorders (Tenth Revision). 1992, Geneva: Diagnostic criteria for research World Health Organization: The ICD-10 Classification of mental and behavioral disorders (Tenth Revision). 1992, Geneva: Diagnostic criteria for research
18.
go back to reference Sathian B, Sreedharan J, Baboo NS, Sharan K, Abhilash ES, Rajesh E: Relevance of Sample Size Determination in Medical Research. Nepal Journal of Epidemiology. 2010, 1 (1): 4-10. Sathian B, Sreedharan J, Baboo NS, Sharan K, Abhilash ES, Rajesh E: Relevance of Sample Size Determination in Medical Research. Nepal Journal of Epidemiology. 2010, 1 (1): 4-10.
19.
go back to reference Sathian B: Reporting dichotomous data using Logistic Regression in Medical Research: The scenario in developing countries. Nepal Journal of Epidemiology. 2011, 1 (4): 111-113. Sathian B: Reporting dichotomous data using Logistic Regression in Medical Research: The scenario in developing countries. Nepal Journal of Epidemiology. 2011, 1 (4): 111-113.
20.
go back to reference Fahmida A, Wahab MA, Rahman MM: Pattern of psychiatric morbidity among the patients admitted in a private psychiatric clinic. Bangladesh Journal of Medical Science. 2009, 8 (1–2): 23-28. Fahmida A, Wahab MA, Rahman MM: Pattern of psychiatric morbidity among the patients admitted in a private psychiatric clinic. Bangladesh Journal of Medical Science. 2009, 8 (1–2): 23-28.
21.
go back to reference Mant A, Lansbury G, Bridges-Webb C: Trends in psychotropic drug prescribing in Australia. Med J Aust. 1987, 146 (4): 208-10.PubMed Mant A, Lansbury G, Bridges-Webb C: Trends in psychotropic drug prescribing in Australia. Med J Aust. 1987, 146 (4): 208-10.PubMed
22.
go back to reference Maki P, Veijola J, Jones PB, Murray GK, Koponen H, Tienari P, Miettunen J, Tanskanen P, Wahlberg KE, Koskinen J, Lauronen E, Isohanni M: Predictors of schizophrenia–a review. Br Med Bull. 2005 Jun 9, 73–74: 1-15.CrossRefPubMed Maki P, Veijola J, Jones PB, Murray GK, Koponen H, Tienari P, Miettunen J, Tanskanen P, Wahlberg KE, Koskinen J, Lauronen E, Isohanni M: Predictors of schizophrenia–a review. Br Med Bull. 2005 Jun 9, 73–74: 1-15.CrossRefPubMed
23.
go back to reference Kohrt BA, Speckman RA, Kunz RD, Baldwin JL, Upadhaya N, Acharya NR, Sharma VD, Nepal MK, Worthman CM: Culture in psychiatric epidemiology: Using ethnography and multiple mediator model to assess the relationship of caste with depression and anxiety in Nepal. Ann Hum Biol. 2009, 36: 261-80. 10.1080/03014460902839194.CrossRefPubMedPubMedCentral Kohrt BA, Speckman RA, Kunz RD, Baldwin JL, Upadhaya N, Acharya NR, Sharma VD, Nepal MK, Worthman CM: Culture in psychiatric epidemiology: Using ethnography and multiple mediator model to assess the relationship of caste with depression and anxiety in Nepal. Ann Hum Biol. 2009, 36: 261-80. 10.1080/03014460902839194.CrossRefPubMedPubMedCentral
24.
go back to reference Lesen E, Anderrson K, Petzoid M, Carlsten A: Socioeconomic determinants of Psychotropic drug utilization among elderly: a national population based cross sectional study. BMC Publ Health. 2010, 10: 118-10.1186/1471-2458-10-118.CrossRef Lesen E, Anderrson K, Petzoid M, Carlsten A: Socioeconomic determinants of Psychotropic drug utilization among elderly: a national population based cross sectional study. BMC Publ Health. 2010, 10: 118-10.1186/1471-2458-10-118.CrossRef
25.
go back to reference Foster HD: The Geography of Schizophrenia: Possible Links with Selenium and Calcium Deficiencies, Inadequate Exposure to Sunlight and Industrialization. Journal of Orthomolecular Medicine. 1988, 3 (3): 135-40. Foster HD: The Geography of Schizophrenia: Possible Links with Selenium and Calcium Deficiencies, Inadequate Exposure to Sunlight and Industrialization. Journal of Orthomolecular Medicine. 1988, 3 (3): 135-40.
26.
go back to reference Banerjee I, Roy B, Sathian B, Banerjee I, Kumar SS, Saha A: Medications for Anxiety: A Drug utilization study in Psychiatry Inpatients from a Tertiary Care Centre of Western Nepal. Nepal Journal of Epidemiology. 2010, 1 (4): 119-25. Banerjee I, Roy B, Sathian B, Banerjee I, Kumar SS, Saha A: Medications for Anxiety: A Drug utilization study in Psychiatry Inpatients from a Tertiary Care Centre of Western Nepal. Nepal Journal of Epidemiology. 2010, 1 (4): 119-25.
27.
go back to reference Banerjee I, Roy B, Banerjee I, Sathian B, Mondol M, Saha A: Depression and its Cure: A Drug Utilization Study from a Tertiary Care Centre of Western Nepal. Nepal Journal of Epidemiology. 2011, 1 (5): 144-52.CrossRef Banerjee I, Roy B, Banerjee I, Sathian B, Mondol M, Saha A: Depression and its Cure: A Drug Utilization Study from a Tertiary Care Centre of Western Nepal. Nepal Journal of Epidemiology. 2011, 1 (5): 144-52.CrossRef
28.
go back to reference Alam K, Mishra P, Prabhu M, Shankar PR, Palaian S, Bhandari RB, Bista D: A study on rational drug prescribing and dispensing in outpatients in a tertiary care teaching hospital of Western Nepal. Kathmandu Univ Med J (KUMJ). 2006, 4 (4): 436-43. Alam K, Mishra P, Prabhu M, Shankar PR, Palaian S, Bhandari RB, Bista D: A study on rational drug prescribing and dispensing in outpatients in a tertiary care teaching hospital of Western Nepal. Kathmandu Univ Med J (KUMJ). 2006, 4 (4): 436-43.
29.
go back to reference Upadhyay KD, Palaian S, Shankar PR, Mishra P: Rational drug prescribing and dispensing in a tertiary care teaching hospital of Western Nepal. Journal of Institute of Medicine. 2008 Aug, 30 (2): 33-38. Upadhyay KD, Palaian S, Shankar PR, Mishra P: Rational drug prescribing and dispensing in a tertiary care teaching hospital of Western Nepal. Journal of Institute of Medicine. 2008 Aug, 30 (2): 33-38.
30.
go back to reference Shankar PR, Partha P, Nagesh S: Prescribing pattern in medical outpatients. Int J Clin Pract. 2002, 56: 549-51. Shankar PR, Partha P, Nagesh S: Prescribing pattern in medical outpatients. Int J Clin Pract. 2002, 56: 549-51.
31.
go back to reference Steinman MA, Chren MM, Landefeld CS: What's in a name? Use of brand versus generic drug names in United States outpatient practice. J Gen Intern Med. 2007 May, 22 (5): 645-8. 10.1007/s11606-006-0074-3.CrossRefPubMedPubMedCentral Steinman MA, Chren MM, Landefeld CS: What's in a name? Use of brand versus generic drug names in United States outpatient practice. J Gen Intern Med. 2007 May, 22 (5): 645-8. 10.1007/s11606-006-0074-3.CrossRefPubMedPubMedCentral
32.
go back to reference Kafle KK, Prasad RR, Thapa BB: National List of Essential Medicine (forth revision draft). 2010, Kathmandu: Nepalese National Formulary, 443-2 Kafle KK, Prasad RR, Thapa BB: National List of Essential Medicine (forth revision draft). 2010, Kathmandu: Nepalese National Formulary, 443-2
33.
go back to reference Bret P, Bret MC, Queuille E: Prescribing patterns of antipsychotics in 13 French psychiatric hospitals. Encephale. 2009, 35 (2): 129-38. 10.1016/j.encep.2008.03.007. Epub 2008 Jul 7CrossRefPubMed Bret P, Bret MC, Queuille E: Prescribing patterns of antipsychotics in 13 French psychiatric hospitals. Encephale. 2009, 35 (2): 129-38. 10.1016/j.encep.2008.03.007. Epub 2008 Jul 7CrossRefPubMed
34.
go back to reference Hurley SF, McNeil JJ, Jolley DJ, Harvey R: Linking prescription and patient-identifying data: a pilot study. Med J Aust. 1992 Mar 16, 156 (6): 383-6.PubMed Hurley SF, McNeil JJ, Jolley DJ, Harvey R: Linking prescription and patient-identifying data: a pilot study. Med J Aust. 1992 Mar 16, 156 (6): 383-6.PubMed
35.
go back to reference Dutta SB, Dhasmana DC, Bhardwaj R: Psychotropic drug utilization pattern among patients with schizophrenia. Indian J Psychiatry. 2005 Oct, 47 (4): 243-4. 10.4103/0019-5545.43066.CrossRefPubMedPubMedCentral Dutta SB, Dhasmana DC, Bhardwaj R: Psychotropic drug utilization pattern among patients with schizophrenia. Indian J Psychiatry. 2005 Oct, 47 (4): 243-4. 10.4103/0019-5545.43066.CrossRefPubMedPubMedCentral
36.
go back to reference Piparva KG, Parmar DM, Singh AP, Gajera MV, Trivedi HR: Drug utilization study of psychotropic drugs in outdoor patients in a teaching hospital. Indian J Psychol Med. 2011 Jan, 33 (1): 54-8. 10.4103/0253-7176.85396.CrossRefPubMedPubMedCentral Piparva KG, Parmar DM, Singh AP, Gajera MV, Trivedi HR: Drug utilization study of psychotropic drugs in outdoor patients in a teaching hospital. Indian J Psychol Med. 2011 Jan, 33 (1): 54-8. 10.4103/0253-7176.85396.CrossRefPubMedPubMedCentral
37.
go back to reference Bret MC, Bret P, Pariente A, Fourier-Réglat A: The use of atypical antipsychotics in French psychiatric hospitals. Pharm World Sci. 2007, 29 (5): 551-6. 10.1007/s11096-007-9107-1. Epub 2007 Jul 19CrossRefPubMed Bret MC, Bret P, Pariente A, Fourier-Réglat A: The use of atypical antipsychotics in French psychiatric hospitals. Pharm World Sci. 2007, 29 (5): 551-6. 10.1007/s11096-007-9107-1. Epub 2007 Jul 19CrossRefPubMed
38.
go back to reference Kafle KK, Prasad RR, Thapa BB: National List of Essential Medicine (forth revision draft). 2010, Kathmandu: Nepalese National Formulary, 140-144. 2 Kafle KK, Prasad RR, Thapa BB: National List of Essential Medicine (forth revision draft). 2010, Kathmandu: Nepalese National Formulary, 140-144. 2
39.
go back to reference Serretti A, De Ronchi D, Lorenzi C, Berardi D: New antipsychotics and schizophrenia: a review on efficacy and side effects. Curr Med Chem. 2004 Feb, 11 (3): 343-58. 10.2174/0929867043456043.CrossRefPubMed Serretti A, De Ronchi D, Lorenzi C, Berardi D: New antipsychotics and schizophrenia: a review on efficacy and side effects. Curr Med Chem. 2004 Feb, 11 (3): 343-58. 10.2174/0929867043456043.CrossRefPubMed
40.
go back to reference Komossa K, Rummel-Kluge C, Hunger H, Schmid F, Schwarz S, Duggan L, Kissling W, Leucht S: Olanzapine versus other atypical antipsychotics for schizophrenia. Cochrane Database Syst Rev. 2010 Mar 17, 3: CD006654 Komossa K, Rummel-Kluge C, Hunger H, Schmid F, Schwarz S, Duggan L, Kissling W, Leucht S: Olanzapine versus other atypical antipsychotics for schizophrenia. Cochrane Database Syst Rev. 2010 Mar 17, 3: CD006654
Metadata
Title
Socio demographic profile and utilization pattern of antipsychotic drugs among schizophrenic inpatients: a cross sectional study from western region of Nepal
Authors
Indrajit Banerjee
Bedanta Roy
Brijesh Sathian
Indraneel Banerjee
Prasanta Kumar Chakraborty
Archana Saha
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2013
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-13-96

Other articles of this Issue 1/2013

BMC Psychiatry 1/2013 Go to the issue