Consumption of psychotropic medicines at a referral hospital Namibia: findings and implications

Abstract

Setting: In Namibia, the burden of mental illnesses is estimated at 25.6% and is expected to double by 2025. Few studies in sub-Saharan Africa estimate the consumption rates of psychotropic medicines as a proxy of irrational use.
 Aim: The consumption rate of psychotropic medicines at a referral hospital was determined.
 Method: A hospital-based retrospective medicine utilization analysis of Facility Electronic Stock Card (FESC) psychotropic medication was conducted at Intermediate Hospital Katutura over a 7 year period, 2011-2017. Data on consumption and expenditure on psychotropic medicines were abstracted from FESC and analysed using descriptive statistics in SPSS v22. The main outcomes were consumption rates, daily Defined Dose, (DDD) and/or expenditure.
 Results: Of the 580 351,4 DDD of psychotropic medicines consumed, 84% were anti-psychotics, 9.2% anti-depressants and 6.8% anxiolytics. Anti-psychotics (48.8%) and anxiolytics (47.9%) had the highest consumption by cost relative to anti- depressants (3.3%). The most consumed antidepressants were imipramine (62%) by DDD and fluoxetine (55.8%) by cost. The most consumed anti-psychotics were chlorpromazine (74.6%) by DDD and haloperidol (68.4%) by cost respectively. Diazepam (79.4%) and hydroxyzine (94.2%) were most consumed sedative-hypnotics by DDD and cost respectively.
 Conclusion: The consumption of new psychotropics contributes to higher costs. There is need for cost-effectiveness anal- ysis of new versus conventional psychotropics to optimize treatment, outcomes and costs.
 Keywords: Pyschotropics, consumption rate, DDD, Namibia.

An interventional pilot of customized adherence enhancement combined with long-acting injectable antipsychotic medication (CAE-L) for poorly adherent patients with chronic psychotic disorder in Tanzania

“…The study is part of a larger U.S. National Institute of Mental Health (NIMH)-funded trial described in greater detail elsewhere [15]. The LAI used in the study, haloperidol decanote, is widely available for the treatment of individuals with CPD in SSA [7,16]. The behavioral intervention used in the study (Customized Adherence Enhancement/CAE) was delivered by social workers who were trained to follow a detailed curriculum.…”

“…Reflecting the broad use of antipsychotic medications, a recent report from Namibia found that antipsychotic medications were the most widely consumed psychotropic medicines (84% were anti-psychotics) vs. 9.2% anti depressants and 6.8% anxiolytics [7]. Because a major impediment to adherence in CPD is difficulty with consistent medication routines, long-acting injectable antipsychotic medication (LAI) can be a potentially efficient and effective treatment option [8,9].…”