Prevalence, socio-demographic and clinical correlates of polypharmacy in schizophrenia

A total of 169 patients with a primary diagnosis of schizophrenia according to ICD-10 or ICD- 11 will be approached. The diagnosis of schizophrenia will be reconfirmed as per ICD- 11 by a clinical interview. Those who satisfy the inclusion, exclusion criteria will be enrolled in the study after obtaining written informed consent from the patient/Nominated Representative. The socio-demographic details shall be recorded in the semi-structured proforma prepared for this study and the information about the current psychotropic treatment prescribed will be noted from the OPD treatment card and screened for polypharmacy using the operational definition of ‘being prescribed 2 or more psychotropics for the same clinical condition’ and prolonged psychotropic polypharmacy definition of ‘being prescribed 2 or more psychotropics for a period of 2 or more months’. On the patients who are identified to be on polypharmacy according to the definitions, the severity of current psychopathology will be assessed by applying Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression- severity scale (CGI- S), Global Assessment of Functioning (GAF) scale, Montreal Cognitive Assessment scale- Hindi (H- MoCA), Calgary Depression Scale for Schizophrenia (CDSS) and Young Mania Rating Scale (YMRS). The quality of life will be assessed by applying WHO Quality of Life scale- Brief Hindi (WHO QoL- BREF). The common side effects of the psychotropics will be assessed with the side effect checklist prepared for this study. The reasons for polypharmacy/symptoms experienced by the patient prior to starting each new drug will be asked to the patient and accompanying reliable informant using the checklist of common reasons of polypharmacy and in case the patient or the informant does not know the reasons/ symptom, the patient’s file record will be examined and the reason for polypharmacy that was documented in the follow-ups will be noted. The reasons for polypharmacy will then be further classified into broad types of polypharmacy. The entire procedure will take 70-80 minutes.