Department of Pharmaceutics, College of Medicine and Health Science, School of Pharmacy, University of Gondar, Gondar, Ethiopia.
Department of Pharmacy, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia.
Int J Neuropsychopharmacol. 2021 Dec 8;24(12):956-964. doi: 10.1093/ijnp/pyab046.
In Africa, antipsychotic polypharmacy (APP) is increasing due to a high antipsychotic dose prescribing, repeated psychiatric hospitalization, uncontrolled psychotic symptoms, and greater side effect burden. Therefore, the aim of this review and meta-analysis is to assess the prevalence and correlates of APP among patients with schizophrenia in Africa.
A systematic search was performed from August 1 to 31, 2020, on PubMed, MEDLINE, Google Scholar, and Science Direct databases to select articles based on the inclusion criteria. Meta-Analysis of Observational studies in Epidemiology guidelines were employed. Cross-sectional observational studies that reported APP and/or its correlates in schizophrenia patients in English language published in peer-reviewed journals without time limits were included in the review. The quality of included articles was assessed using Newcastle-Ottawa quality assessment tool. Prevalence and correlates of APP were the outcome measures of this review and meta-analysis. Open Meta Analyst and RevMan version 5.3 software were used for meta-analysis. A random effect model was used to synthesize data based on the heterogeneity test.
Six studies that involved 2154 schizophrenia patients met the inclusion criteria in this review and meta-analysis. The quality of included studies ranges from 6.5 to 10 based on the Newcastle-Ottawa quality assessment tool. The pooled prevalence of APP among patients with schizophrenia was 40.6% with 95% confidence interval: 27.6% to 53.7%. Depot first-generation antipsychotics and oral first-generation antipsychotics were the most commonly prescribed APP combinations. Socio-demographic, clinical, and antipsychotic treatment characteristics were significantly associated with APP. There was a wide variation in the correlates of APP assessed by studies and the way that association/correlations was determined and reported.
APP is common and highly prevalent. Advanced age, male gender, longer duration of schizophrenia, hospital admission, and longer antipsychotic treatment were correlates of APP in Africa.
在非洲，由于抗精神病药高剂量处方、反复精神科住院、未控制的精神病症状和更大的副作用负担，抗精神病药联合用药（APP）正在增加。因此，本综述和荟萃分析的目的是评估非洲精神分裂症患者中 APP 的患病率和相关因素。
2020 年 8 月 1 日至 31 日，我们在 PubMed、MEDLINE、Google Scholar 和 Science Direct 数据库中进行了系统检索，根据纳入标准筛选文章。采用观察性研究荟萃分析的流行病学指南。纳入了以英语发表的、无时间限制的、在同行评议期刊上发表的、报告 APP 及其在精神分裂症患者中的相关性的 APP 的横断面观察性研究。使用纽卡斯尔-渥太华质量评估工具评估纳入文章的质量。APP 的患病率和相关因素是本综述和荟萃分析的结果测量指标。Open Meta Analyst 和 RevMan 版本 5.3 软件用于荟萃分析。根据异质性检验，使用随机效应模型综合数据。
本综述和荟萃分析共纳入了 6 项研究，涉及 2154 例精神分裂症患者。根据纽卡斯尔-渥太华质量评估工具，纳入研究的质量范围为 6.5 至 10。精神分裂症患者 APP 的总体患病率为 40.6%，95%置信区间为 27.6%至 53.7%。长效第一代抗精神病药和口服第一代抗精神病药是最常联合使用的 APP。社会人口统计学、临床和抗精神病药物治疗特征与 APP 显著相关。研究评估的 APP 相关因素以及确定和报告关联/相关性的方式存在很大差异。
APP 很常见且高度流行。在非洲，APP 的相关因素包括年龄较大、男性、精神分裂症病程较长、住院和抗精神病药物治疗时间较长。
