Drug Prescribing Pattern and Cost Analysis of Antipsychotics at a Tertiary Care Hospital in South India

S. Vedha Pal Jeyamani1*, Asha K Rajan1, R Gowri1, R Monica1, M Prema1, M Mohamed Javith1, M Murugan2

Aim: The aim of the present study was to analyze the cost of Psychiatric drugs in the elderly and to evaluate potentially inappropriate medications (PIMs) in them at the Neurology Outpatient department of a tertiary care hospital using Beers criteria and factors associated with it. Study design: An observational cross-sectional study was carried out in the elderly patients aging ≥ 60 years from the Neurology OPD department for a period of 6 months. PIMS and other risk factors were identified with the help of Beers 2015 criteria. Direct cost of prescribed drugs was calculated making use of guidelines like CIMS, MIMS etc., Results and discussion: Among the psychological conditions evaluated Epilepsy (23.6%) and Schizophrenia (15.6%) were found to be more common among others. Sedative-Hypnotics (39.2%) and anti-epileptics (23.6%) were the commonly prescribed category of drugs. Cost-ratio analysis of Anti-psychotics was found to vary greater when compared to others. Olanzapine (1:12), Chlorpromazime (1:5.1) and Risperidone (1:15) were the prescribed anti-psychotics. All other categories of drugs were found to comply to certain extent with economic status of patients. Antidepressants prescribed posed about 30% patients with PIMs. Typical and atypical anti-psychotics also were PIM with a percentage of 25.7%. Other PIMs due to disease, drug interactions were also studied. Conclusion: A cost-effective management with availing of more economic therapy to the patients could be carried by a clinical pharmacist. Programs encouraging the prescribing of generic drug practice and their benefits compared to brand drugs could be clearly worked out bring more awareness to public.