Abstract

Objective: Little is known about the prescription pattern of psychotropic drugs for patients with schizophrenia in Pakistan. The purpose of this study was to evaluate the characteristic features of psychotropic drug prescriptions for patients with schizophrenia in Pakistan. Methods: Three centers in Pakistan participated in a large scale collaborative study known as Research on Asian Prescription Pattern (REAP). The 2016 REAP survey included centers from 15 countries in Asia and used a unified research protocol. The design of the study was quantitative and of descriptive epidemiology. Analysis was made on the data collected from three centers i.e., Lahore, Karachi and Islamabad. The data collected in Pakistan were compared with those from other Asian countries. The details of REAP were presented on the homepage of REAP (http://www.REAP.Asia). Results: From Pakistan, 298 patients were included. Patients with schizophrenia in Pakistan received higher rate of antipsychotic polypharmacy and a higher rate of co-prescription of mood stabilizers and anxiolytics when compared with participants from other South Asian countries (India and Bangladesh). Conclusion: The main findings of the study were that a majority of the patients were prescribed antipsychotic polypharmacy drugs in Pakistan. Insufficient training on the use of psychotropic drugs and a lack of treatment guideline are considered to be the major contributing factors. Further education and training on the proper use of psychotropic drugs are recommended to psychiatrists in Pakistan. The guidelines on pharmacotherapy for patients with schizophrenia should also be developed and promoted in Pakistan.

Highlights

  • The Research on East Asian Psychotropic Prescription Pattern (REAP) is the largest and the longest standing international collaborative research project in Asia

  • Before centers in Pakistan participated in the REAP survey for the first time in 2016, little was known about the prescription pattern of psychotropic drugs in Pakistan

  • Mental health services in Pakistan have been shown by the World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS)

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Summary

Introduction

The Research on East Asian Psychotropic Prescription Pattern (REAP) is the largest and the longest standing international collaborative research project in Asia. REAP has been a large scale survey of prescription patterns of patients with schizophrenia in different countries in Asia since 2001 [1], [2]. Before centers in Pakistan participated in the REAP survey for the first time in 2016, little was known about the prescription pattern of psychotropic drugs in Pakistan. This study is the first large scale survey on psychotropic prescription pattern based on a unified research protocol. Psychotropic drugs are mostly widely available at mental hospitals, followed by inpatient units, and outpatient mental health facilities. More than 25,000 medical doctors in other fields and more than 13,000 nurses support mental health services in Pakistan [3]. The number of psychiatrists and nurses available in or around the large cities is greater than that in rural areas in the entire country. Public education and awareness campaigns on mental health are governed by a coordinating body with the help of government agencies [3]

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