<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_gp-2018-0006_s_007_w2aab3b7b1b1b6b1aab1c14b1Aa"><h3>Objectives</h3><p>To describe the range and frequency of psychotropics used in the management of bipolar disorder in a specific setting as well as describe the nature and frequency of monotherapy versus polypharmacy use. Specifically to determine congruence with recommended standard of care that might inform a review and refinement of prescribing within this context.</p></sec><sec id="j_gp-2018-0006_s_008_w2aab3b7b1b1b6b1aab1c14b2Aa"><h3>Methods</h3><p>The study was a retrospective file review for patients with bipolar disorder (ICD 10 and or DSM IV TR diagnostic criteria) attending the outpatient clinic of a specialised psychiatric hospital (Tara Hospital) affiliated to the Department of Psychiatry (University of the Witwatersrand) in Johannesburg, South Africa. Data were presented both descriptively (continuous, discrete and categorical data) and with a range of appropriate statistical tests used for associations between categorical data (Chi Square; Fisher’s exact test; Cramer’s V and the phi coefficient).</p></sec><sec id="j_gp-2018-0006_s_009_w2aab3b7b1b1b6b1aab1c14b3Aa"><h3>Results</h3><p>The majority of patients (93.8%) were prescribed polypharmacy, with 3.2 as the mean number of psychotropic medications prescribed per patient (as determined from the last prescription written during the period of review, i.e. one year). There was a notable variety in the combinations used with no particular combination being prescribed in the majority of patients, noting, however, that 47% of the combinations used included a standard mood stabiliser prescribed together with an antipsychotic.</p></sec><sec id="j_gp-2018-0006_s_010_w2aab3b7b1b1b6b1aab1c14b4Aa"><h3>Conclusions</h3><p>The current study provides data on the prescribing patterns for bipolar disorder in a specialist psychiatric clinic within an academic complex in South Africa. The findings reflect international studies and highlight polypharmacy and combination treatment as common in such settings. Where polypharmacy is prescribed, the variation in combinations prescribed indicate that whilst treatment guidelines may provide a best practice approach, studies determining the most useful combinations are few and ultimately clinical requirements for individual patients will dictate treatment.</p></sec></abstract>

ObjectivesTo describe the range and frequency of psychotropics used in the management of bipolar disorder in a specific setting as well as describe the nature and frequency of monotherapy versus polypharmacy use. Specifically to determine congruence with recommended standard of care that might inform a review and refinement of prescribing within this context.MethodsThe study was a retrospective file review for patients with bipolar disorder (ICD 10 and or DSM IV TR diagnostic criteria) attending the outpatient clinic of a specialised psychiatric hospital (Tara Hospital) affiliated to the Department of Psychiatry (University of the Witwatersrand) in Johannesburg, South Africa. Data were presented both descriptively (continuous, discrete and categorical data) and with a range of appropriate statistical tests used for associations between categorical data (Chi Square; Fisher’s exact test; Cramer’s V and the phi coefficient).ResultsThe majority of patients (93.8%) were prescribed polypharmacy, with 3.2 as the mean number of psychotropic medications prescribed per patient (as determined from the last prescription written during the period of review, i.e. one year). There was a notable variety in the combinations used with no particular combination being prescribed in the majority of patients, noting, however, that 47% of the combinations used included a standard mood stabiliser prescribed together with an antipsychotic.ConclusionsThe current study provides data on the prescribing patterns for bipolar disorder in a specialist psychiatric clinic within an academic complex in South Africa. The findings reflect international studies and highlight polypharmacy and combination treatment as common in such settings. Where polypharmacy is prescribed, the variation in combinations prescribed indicate that whilst treatment guidelines may provide a best practice approach, studies determining the most useful combinations are few and ultimately clinical requirements for individual patients will dictate treatment.

Pharmacotherapy prescribing patterns in the treatment of bipolar disorder in a South African outpatient population

Global Psychiatry

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

ObjectivesTo describe the range and frequency of psychotropics used in the management of bipolar disorder in a specific setting as well as describe the nature...

Variable	Category	N	%
Age	18-35y	65	26.86
	36-50y	89	36.78
	51-64y	70	28.93
	65y+	18	7.44
Gender	Male	77	31.82
Gender	Female	165	68.18
Hospital Fee Classification	H0	19	7.85
	H1	159	65.70
	H2	42	17.36
	Private	14	5.79
	Others	8	3.31

category	Number of patient samples per category (total n = 242)
Number of psychotropics	N	%
1	15	6.20
2	55	22.73
3	84	34.71
4	52	21.49
≥5	36	14.88

Variable	Category	N	%
Bipolar disorder subtype	Type I	166	68.60
	Type II	56	23.14
	NOS	20	8.26
Psychiatric comorbidity	Yes	117	48.35
Psychiatric comorbidity	No	125	51.65

Pharmacotherapy prescribing patterns in the treatment of bipolar disorder in a South African outpatient population

Published Online: Jul 28, 2018

Page range: 39 - 52

Received: Mar 08, 2018

Accepted: May 30, 2018

DOI: https://doi.org/10.2478/gp-2018-0006

Keywords
Drug therapy, bipolar disorder, outpatient, South Africa

© 2018 Eleanor Mari Holzapfel, Christopher Paul Szabo, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Figure 2

Figure 3

Demographic characteristics of patients (total n = 242).

Number of psychotropics prescribed to patients.

Bipolar type and comorbidity profile of patients (total n = 242).

Pharmacotherapy prescribing patterns in the treatment of bipolar disorder in a South African outpatient population

Published Online: Jul 28, 2018

Page range: 39 - 52

Received: Mar 08, 2018

Accepted: May 30, 2018

DOI: https://doi.org/10.2478/gp-2018-0006

KeywordsDrug therapy, bipolar disorder, outpatient, South Africa

© 2018 Eleanor Mari Holzapfel, Christopher Paul Szabo, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Figure 2

Figure 3

Demographic characteristics of patients (total n = 242).

Number of psychotropics prescribed to patients.

Bipolar type and comorbidity profile of patients (total n = 242).

Keywords
Drug therapy, bipolar disorder, outpatient, South Africa