Antipsychotic Polypharmacy and Associated Factors among Patients with Schizophrenia at Comprehensive Specialized Hospitals in the Northwest Ethiopia: a Multicenter Cross-sectional Study, 2022

Abstract Background : Antipsychotic polypharmacy refers to the co-prescription of more than one antipsychotic drug for a particular patient. Despite recommendations by guidelines to minimize combinations of antipsychotics except after repeated trial of antipsychotic monotherapy, it is quite a frequent practice to utilize combinations. Objective : This study aimed to assess antipsychotic polypharmacy and its associated factors among patients with schizophrenia at Comprehensive Specialized Hospitals in Northwest Ethiopia. Method : A cross sectional study was conducted among 422 patients with schizophrenia using systematic random sampling. The Alcohol, Smoking and Substance Involvement Screening Test, were used to measure substance use. Data entry and analysis were done using Epi-data version 4.6.1 and SPSS version 24 respectively. Binary logistic regression was applied to identify factors associated with antipsychotic polypharmacy. Variables with a p-value < 0.05 at a 95% confidence interval were considered as statistically significant. Result : The overall prevalence of antipsychotic polypharmacy was 22.7% (CI: 19 - 27). Duration of illness (AOR: 2.88; CI: 1.49, 5.59), duration of treatment (AOR: 3.79; CI: 1.05, 13.62), number of admission (AOR: 4.93; CI: 2.52, 9.64) and substance use (AOR: 2.58; CI: 1.49, 4.47) were significantly associated with antipsychotic polypharmacy. Conclusion and recommendation : In this study, antipsychotic polypharmacy was recorded in considerable amount of patients. Duration of illness, duration of treatment, number of admissions, and substance use were significantly associated with antipsychotic polypharmacy. Therefore, clinicians and other responsible stakeholder groups should identify interventions that need to be implemented to improve antipsychotic utilization.