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尼日利亚北部两家地区精神病医院的精神药物处方情况。

Psychotropic drugs prescription at two regional psychiatric hospitals in northern Nigeria.

作者信息

Adeponle A B, Obembe A O, Nnaji F, Adeyemi S O, Suleiman G T

机构信息

Federal Neuro-Psychiatric Hospital, Kaduna, Nigeria.

出版信息

West Afr J Med. 2008 Apr;27(2):106-10.

Abstract

BACKGROUND

Studies on psychotropic drug prescription in Nigeria are few, limited to the south and over a decade old. With the recent advances in psychopharmacology an audit is desirable.

OBJECTIVE

To describe the practice and pattern of psychotropic drugs prescription for new patients attending out-patient clinic in two Federal Neuro-Psychiatric Hospitals in Northern Nigeria and to identify extent of potential drug-drug interaction in the prescriptions.

METHODS

A cross-sectional study, using charts review, on new patients seen over a month at the out-patient clinics of two regional psychiatric hospitals in Northern Nigeria.

RESULTS

Two hundred and seventy-eight patients were seen. Conventional antipsychotics were the most prescribed (68%), anticholinergic (62%), tricyclic antidepressants (35%), anticonvulsants (25%), benzodiazepines (8%). SSRIs were given to 2% of patients, while no patient was given an atypical antipsychotic. Physicians did not inquire about patients medical and medication histories, nor perform physical examinations in most cases. Polypharmacy was high, giving rise to significant potential drug-drug interactions in 28% of patients.

CONCLUSION

Prescription practices are far from ideal, and continuing education, as well as development of prescription practice guidelines is suggested. Government intervention and change in clinician attitudes may be needed to improve use of newer medications.

摘要

背景

尼日利亚关于精神药物处方的研究较少,仅限于该国南部且距今已有十多年。随着精神药理学的最新进展,进行一次审查是很有必要的。

目的

描述尼日利亚北部两家联邦神经精神病医院门诊新患者的精神药物处方实践和模式,并确定处方中潜在药物相互作用的程度。

方法

采用图表回顾法,对尼日利亚北部两家地区精神病医院门诊一个月内就诊的新患者进行横断面研究。

结果

共诊治278例患者。最常开具的药物是传统抗精神病药(68%)、抗胆碱能药物(62%)、三环类抗抑郁药(35%)、抗惊厥药(25%)、苯二氮䓬类药物(8%)。2%的患者使用了选择性5-羟色胺再摄取抑制剂(SSRI),而无患者使用非典型抗精神病药。大多数情况下,医生未询问患者的病史和用药史,也未进行体格检查。联合用药情况普遍,28%的患者存在显著的潜在药物相互作用。

结论

处方实践远非理想,建议开展继续教育并制定处方实践指南。可能需要政府干预和临床医生态度的转变,以促进新型药物的使用。

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