Prescription audit and drug utilization pattern in outpatients of psychiatry department of tertiary care teaching hospital: an observational study

Abstract

Background: The domain of psychiatric illnesses is grossly underrepresented in the current health care scenario especially due to overreliance on mortality rather than the morbidity or dysfunction. The field of psycho-pharmacology is witnessing constant development and introduction of new drugs for which holistic utilization, effectiveness, and side effects studies are the need of the hour. In addition, inappropriate use of drugs poses a potential hazard to patients. Our current study aims at studying the morbidity pattern of various psychiatric ailments and focuses on the prescribing trends of psychotropic drugs.Methods: A prospective observational study was conducted in psychiatry out-patient department of a tertiary care hospital for a period of 12 months. Prescription pattern of psychotropic drugs was analyzed using predesigned format. Prescriptions were collected from OPD and hospital pharmacy. Prescriptions were analysed as per WHO indicators for prescriptions. Descriptive statistics were used for analysis.Results: Depression was found to be the most common psychiatric disorder encountered (32.6%). Average number of psychotropic drugs prescribed per patient 2.45±1.013. Antidepressants along with BZD were the most frequently prescribed psychotropic drugs in various psychiatric disorders. Among the total of 2445 psychotropic drugs prescribed, 99.98% were oral formulations. Psychotropic fixed dose combinations were present in 1.68% of the prescriptions. Only 28% of medicines were prescribed by generic names. Utilization of drugs from the WHO’s 18th list of essential medicines of India was 29%. PDD of risperidone was 1.57mg in schizophrenia. Escitalopram, resperidone and propranolol were the most commonly prescribed drugs for mood disorders, schizophrenia and anxiety respectively.Conclusions: The concomitant use of two psychotropic drugs was the preferred therapy. FDC of anti-cholinergics with both typical and atypical antipsychotics were used. Benzodiazepins were significant part of therapy.