Prescription Pattern, follow-up pattern, and medication adherence in psychiatric outpatients

Abstract

Background: Drug utilization research on psychotropic drug use facilitates rational prescriptions in psychiatric patients. Low follow-up rates and nonadherence to psychotropic medications are key challenges in psychiatry. The objective of this study was to determine the prescription pattern of psychotropic medications, the follow-up pattern, and medication adherence in psychiatric outpatients. Materials and Methods: In this retrospective observational study, the prescription pattern and number of follow-ups were abstracted for each new psychiatric outpatient for a period of 6 months from the time of the first assessment. In addition, medication adherence was assessed using a secondary database analysis. A continuous measure of medication acquisition (CMA) was calculated and those patients with CMA of 0.8 or more were considered adherent. Results: A total of 317 patients were included in the study. At the first visit, 198 patients (62.46%) were prescribed two psychotropic medications. Out of the total sample, 157 (49.53%) were prescribed once-daily medication and 151 (47.63%) received twice-daily medication. During the follow-up visits, the primary medication was changed in 40 (12.62%) patients and polypharmacy was used in 23 (7.26%) patients. After the initial visit, 138 (43.53%) patients did not come for even a single follow-up visit. Only 50 (15.77%) patients had a medication prescription for at least 80% of the study period. Conclusion: Olanzapine, escitalopram, sertraline, and clonazepam were the most commonly prescribed psychotropic medications. Most patients were prescribed two psychotropic medications which included one benzodiazepine. However, polypharmacy was an uncommon practice. Follow-up rate and medication adherence were poor across different diagnostic categories.

Keywords

• anxiety disorder
• depressive disorder
• drug prescription
• medication persistence
• psychotic disorder