Appropriateness of antipsychotic drugs prescribed for First episode psychosis by clinicians at Chainama Hills college hospital in Lusaka

Abstract

Mental health disorders pose an increasing burden on societies all over the world. Notable one is Psychosis, a debilitating condition that presents as marked distortion in thinking and perception, whose first presentation of symptoms in a newly diagnosed patient requires accurate and evidence based drug treatment. Patients with first episode psychosis may present in a variety of clinical settings to providers who have a range of knowledge and skills. This study aimed to assess the appropriateness of antipsychotic drugs prescribed by clinicians in the management of first episode psychosis. A cross sectional study to assess appropriateness of antipsychotic drugs prescribed in the management of first episode psychosis using convenient sampling method and the NICE 2014 antipsychotic treatment guidelines as gold standard was conducted at Chainama hills college hospital in Lusaka. There were a total of 31 prescribers assessed for this study 38.7% psychiatrists and 61.3% clinical officer psychiatrists. The proportional difference of the two groups of prescribers assessed was not statistically significant, P-value = 0.21. Risperidone was the most frequently chosen antipsychotic with 58.1% of the respondents. Overall, there were 96.8% prescribers who did not prescribe anti psychotics in line with published guidelines. 3.2% of prescriber did prescribe in line with NICE 2014 guidelines. The front-line clinicians who encounter patients with first episode psychosis may have significant gaps in the initial and follow-up care of these patients. Given the preliminary nature of this study and the debate about the optimal care for first episode psychosis, further study with larger sample size is needed. If such gaps are confirmed additional educational interventions are required to align clinical management with published practice guidelines