ANTIPSYCHOTIC MEDICATION SWITCH AND ITS DETERMINANTS AMONG AMBULATORY PATIENTS WITH SCHIZOPHRENIA IN NORTHWEST ETHIOPIA: A CROSS-SECTIONAL STUDY.

Abstract

ABSTRACT Introduction:Schizophrenia is a psychiatric condition that can lead to long-term incapacity as well as social and career problems. Schizophrenia affects 20 million individuals worldwide, with a particularly high burden in low and middle-income nations. Unavailablity of the medication,adverse effect and poor treatment response are the main reason for switching. Objective:Thisstudyaims to assess the prevalence of antipsychotic medication switch and associated factors among patients with schizophrenia at Northwest Ethiopia. Methods: A hosital based cross-sectional study was conducted at five Comprehensive Specialized Hospitals found in Northwest Ethiopia from April 30, 2021,to August 30, 2021. All patients with schizophrenia whovisited the psychiatry outpatient department during the study period were included in the study. MARS,WHODAS and OSSS were used to assess patients medication adherance,disablity and social support. Data were extracted from patient‘s medical chartsand by interview.Data were entered into Epi-data software, version 3.5.1, and exported to SPSS version 25.0 for analysis. Multivariable logistic regression was applied to identify factors associated with medication regimen switch. The level of significance of the study was kept at a P-value of 0.05 with 95% confidence interval. Result:About 45.5% of patients switched antipsychotics within one-year and unavailablity of the medication is the most common reason for switching. Four variables were shown to be significant predictors of switching.Being male[AOR=2.581,95% CI; (1.463,4.552)], having relapse)[AOR=2.341,95% CI; (1.169,4.687] and hospitillization in the past one year [AOR=3.00,95% CI; (1.478,5.715)], and taking typical antipsychotics [AOR=3.340,CI; (1.768,6)] had significant association with switching. Conclusion:Switching antipsychotics appears to be common in schizophrenia treatment and can be predicted by four variables. Unavilablity and being on typical antipsychotics are among the main reasons for the switch either due to their lack of effect or more severe side effects. Therefore,their prescription has to be limited to certain conditions. Keywords: Schizophrenia, Determinants, Antipsychotics switching, switching stratigies, Northwest, Ethiopia