Optimizing Schizophrenia Care: A Multi-Parameter Evaluation of Antipsychotic Prescribing Rationality

Abstract

Schizophrenia is a chronic mental disorder that requires long-term antipsychotic pharmacotherapy with rational drug use to prevent relapse and improve patients’ quality of life. This study was a descriptive observational study with a retrospective approach aimed at evaluating the rationality of antipsychotic drug use in outpatient schizophrenia patients based on WHO criteria at Hospital X in the Tangerang region, Banten. The study sample consisted of 299 patients who met the inclusion and exclusion criteria, and the analysis was conducted using eight drug use indicators, including indication, patient, drug, dose, frequency, diagnosis, route of administration, and duration of therapy. The results showed that most patients were male (55%) and aged 26–35 years (31.8%), with paranoid schizophrenia as the dominant diagnosis (98%) and hallucinations as the main symptom (80%). Atypical antipsychotics were the main therapy, with risperidone 2 mg being the most frequently prescribed drug (30.6%), and polypharmacy was found in 59% of patients. The accuracy of drug use reached 100% for indication, diagnosis, route of administration, and duration of therapy, and was also high for drug selection (99%), patient (99.3%), and dose (97.7%), while frequency accuracy was lower (82.6%). Overall, antipsychotic use at Hospital X demonstrated a high level of rationality and was aligned with evidence-based practice principles; however, improvements are still needed in dosing frequency accuracy and stronger collaboration between psychiatrists and clinical pharmacists to minimize potential drug-related problems in patients receiving combination therapy.