General polypharmacy, psychotropic polypharmacy, attitudes of patients on psychotropic deprescribing, and associated factors in adult psychiatric outpatients: a survey study in a comprehensive specialized hospital, northwest Ethiopia.

Abstract

Introduction: Excessive polypharmacy causes different problems, including adverse drug reactions and drug-drug interactions. To address the problems, deprescribing has emerged, focusing on reducing the dose or stopping unnecessary medications.

Objective: This study aimed to explore the prevalence of psychotropic polypharmacy, general polypharmacy, deprescribing attitudes and associated factors for psychotropic medications in adult patients with mental disorders.

Materials and methods: A facility-based cross-sectional survey study design was conducted to collect data on 123 patients with mental disorders from April 2022 to August 2024. Revised patients' attitudes towards deprescribing (rPATD), trust in physician score, and orientation memory concentration test were used. Descriptive statistics, one-way analysis of variance, and independent t-tests were used. P-value of 0.05 was a cutoff point to determine significant association.

Results: The prevalence of general polypharmacy and psychiatric polypharmacy was 17.9% [22] and 29.3% [36] respectively. Near to half of patients (54, 44.7%) felt they were taking large number of medications; more than half (69, 56.1%) felt spending a lot of money. Patients with age of > 60 years had significant differences with patients aged from 18 to 44 (p < 0.001) and 45-59 (p < 0.01) years on burden and appropriateness domains respectively. Patients who took < 5 medications had significant difference (p < 0.001) with patients taking ≥ 5 medications on both burden and appropriateness domains.

Conclusion: The findings of the study showed many patients had meaningful prevalence of general polypharmacy and psychotropic polypharmacy. Patients expressed diverse attitudes toward deprescribing, affected by different factors. This study is conducted in a single health facility with small sample size.

Clinical trial number: Not applicable.