INTRODUCTION
This study was carried out to compare the pattern of prescription of psychotropic drugs in two health facilities in south-eastern Nigeria using World Health Organisation/International Network for The Rational Use of Drugs (WHO/INRUD) developed indicators in order to promote the rational prescribing of drugs.
Drug utilisation study promotesthe rational use of medicine. It is indispensable indecision making when it comes to issues pertaining to the clinical and economic standpoints of chemotherapy (Janaki et al., 2011). It is a superb way of studying the patient’s medication and correlating it to the expected outcome of patients as it reveals medication errors and other anomalies that could generally lead to poor patient outcomes. Hence, it won’t be out of place to say that there are a lot of benefits that could be gained when drug utilisation studies are carried out on a regular basis in our heath facilities however, this is not the case as reflected by the scarcity of drug utilisation data in our country with a much lesser amount of this publications relating to the field of mental health and psychiatry (WHO-AIMS, 2006).
Psychiatry is a very sensitive area of health care system and the nature of the practices carried out in mental health facilities should be reviewed from time to time. This is because of the nature of these psychotropic drugs taken by the patients. These drugs pose special risks in that we have only a limited understanding of the full impact of such medications on brain circuitry and they are associated with numerous adverse effect, drug interactions and toxicities, withdrawal symptoms inclusive. Also, the fact that most patients are on long term use of psychotropic drug exposes them to drug therapy problems (DTPs). DTPs can be a consequence of irrational prescribing which is prevalent in many health care systems, especially in developing countries, resulting in poly-pharmacy, overuse of injections and lack of compliance with the principles of essential drug concept (Enato et al., 2011). This leads to issues of non-adherence, relapse, as well as high cost of management.
Hence, avoidance of the occurrence of these drug therapy problems seems prudent and this can only be done with rational prescribing.
A drug utilization study is an effective way of evaluating rationality of the prescribing pattern (Yuen et al., 1998) and without the knowledge of how the drugs are being prescribed; it is difficult to suggest the measures to improve prescribing habits.
This study looks into the prescribing pattern of psychotropic drugs in mental health facilities using the WHO core indicators this will give an insight into the pharmacotherapy rendered in these health facilities for necessary awareness and intervention program which would consequently improve the therapeutic outcome of the patients as well as their quality of life.
Information about the level of mental health service in Nigeria is hard to come by as an estimated 3% of all health publications in the country are on mental health. It is therefore difficult to identify areas of need, to make informed decisions about policy direction, and to monitor progress (WHO-AIMS, 2006).
A lot of issues are on the increase affecting patients’ outcome in the field of psychiatry. This range from increase in the number of available psychotropic agents, to poor response of patients to therapy and high risk of complications. Also, many prescriptions for psychotropic drugs contain so many psychotropic drugs which may expose the patients to disturbing side effects leading to non-adherence.
As a result, there is high degree of non adherence, relapse, polypharmacy, high cost of therapy and a host of other effects that can arise from irrational prescribing and the summation of it all results in non-optimization of drug therapy and therapy failure.
Psychotropic drug utilisation pattern would serve as a mirror to highlight the flaws of the prescribing patterns and consequently help improve overall patients’ outcome.
This study would help to identify areas of need and thus help to make informed decision about policy direction and progress monitoring in health facilities which would inadvertently result in the rational and cost effective management of mental illness. This study is therefore due to the concern regarding psychotropic drug therapy for patients with one form of mental illness or the other.
To compare the pattern of prescription of psychotropic drugs in two health facilities in south-eastern Nigeria using WHO/INRUD developed indicators in order to promote the rational prescribing of drugs.
The study is aimed at determining the following:
Safe and efficacious drugs when used rationally play a very important role in improving health and promoting wellbeing of patients. It is difficult to understand the rational use of drugs without the knowledge of how the drugs are used. Drug utilisation studies like this contribute immensely to rational drug use by describing the drug use pattern and intervention.