A clinical audit of antipsychotic prescriptions and associated clinical profile at Helen Joseph Hospital, Johannesburg, South Africa

Mwenda, Jones
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Background Antipsychotics are a group of agents used to treat symptoms of several psychiatric disorders. Multiple global guidelines recommend treatment with second-generation antipsychotic (SGA) agents as a first line of treatment for psychotic disorders. Aim The aim was to examine the pattern of antipsychotic prescription and associated factors at Helen Joseph Hospital over a six-month period. Methods The researcher conducted a retrospective record review of 104 patients who were treated at various times over six months from 1 July to 31 December 2018. The data on demographic information, psychiatric diagnoses, medication, side effects were extracted from available clinical records. Results The mean age of patients in this study was 35.4 years with more being male (n=65, 62.5%) than female (n=39, 37.5%). Antipsychotics were used mostly for treating psychotic disorders (n=39; 37.5%) followed by mood disorders (n=31; 29.8%), substance-induced disorders (n=26; 25%), and psychiatric disorders due to another medical condition (n=8; 7.7%). Majority of patients were on oral SGAs (n=86), mostly risperidone (n=59) followed by olanzapine (n=24). LAIs were used in 27 cases with flupenthixol (n=17) being the main one. Oral FGAs were used in 13 patients and clozapine was used in four. Three-quarters of the patients (76.2%) were on monotherapy, the only statistically viii significant finding. Risperidone was implicated in most side effects reported (n=8) with EPSEs (n=6) occurring most commonly in the study population. Conclusion The use of antipsychotics at Helen Joseph Hospital was found to be in line with the local Essential Medicines List and global trends.
A research report submitted in partial fulfilment of the requirements for the degree of Master of Medicine in Psychiatry to the Faculty of Health Sciences, School of Clinical Medicine, University of Witwatersrand, Johannesburg, 2022