Objectives In Africa, antipsychotic polypharmacy (APP) is increasing due to a high antipsychotic dose prescribing, repeated psychiatric hospitalization, uncontrolled psychotic symptoms, and greater side effect burden. Therefore, the aim of this review and meta-analysis is to assess the prevalence and correlates of APP among patients with schizophrenia in Africa. Methods A systematic search was performed from August 1 to 31, 2020, on PubMed, MEDLINE, Google Scholar, and Science Direct databases to select articles based on the inclusion criteria. Meta-Analysis of Observational studies in Epidemiology guidelines were employed. Cross-sectional observational studies that reported APP and/or its correlates in schizophrenia patients in English language published in peer-reviewed journals without time limits were included in the review. The quality of included articles was assessed using Newcastle-Ottawa quality assessment tool. Prevalence and correlates of APP were the outcome measures of this review and meta-analysis. Open Meta Analyst and RevMan version 5.3 software were used for meta-analysis. A random effect model was used to synthesize data based on the heterogeneity test. Results Six studies that involved 2154 schizophrenia patients met the inclusion criteria in this review and meta-analysis. The quality of included studies ranges from 6.5 to 10 based on the Newcastle-Ottawa quality assessment tool. The pooled prevalence of APP among patients with schizophrenia was 40.6% with 95% confidence interval: 27.6% to 53.7%. Depot first-generation antipsychotics and oral first-generation antipsychotics were the most commonly prescribed APP combinations. Socio-demographic, clinical, and antipsychotic treatment characteristics were significantly associated with APP. There was a wide variation in the correlates of APP assessed by studies and the way that association/correlations was determined and reported. Conclusions APP is common and highly prevalent. Advanced age, male gender, longer duration of schizophrenia, hospital admission, and longer antipsychotic treatment were correlates of APP in Africa.

中文翻译：

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非洲精神分裂症患者的抗精神病药联合用药：系统评价和荟萃分析

目标 在非洲，由于高剂量抗精神病药处方、反复精神病住院、不受控制的精神病症状和更大的副作用负担，抗精神病药联合用药 (APP) 正在增加。因此，本综述和荟萃分析的目的是评估 APP 在非洲精神分裂症患者中的患病率和相关性。方法 2020 年 8 月 1 日至 31 日，对 PubMed、MEDLINE、Google Scholar 和 Science Direct 数据库进行系统搜索，根据纳入标准选择文章。采用流行病学指南中观察性研究的荟萃分析。横断面观察性研究报告了 APP 和/或其在精神分裂症患者中的相关性，在没有时间限制的同行评审期刊上发表的英语语言的精神分裂症患者被纳入审查。使用纽卡斯尔-渥太华质量评估工具评估纳入文章的质量。APP 的患病率和相关性是本次审查和荟萃分析的结果测量。使用 Open Meta Analyst 和 RevMan 5.3 版软件进行荟萃分析。基于异质性检验，使用随机效应模型合成数据。结果 涉及 2154 名精神分裂症患者的六项研究符合本综述和荟萃分析的纳入标准。根据纽卡斯尔-渥太华质量评估工具，纳入研究的质量范围从 6.5 到 10。精神分裂症患者中 APP 的综合患病率为 40.6%，95% 置信区间：27.6% 至 53.7%。Depot 第一代抗精神病药和口服第一代抗精神病药是最常用的 APP 组合。社会人口学、临床、和抗精神病药物治疗特征与APP显着相关。研究评估的 APP 相关性以及确定和报告关联/相关性的方式存在很大差异。结论 APP普遍且流行。高龄、男性、较长的精神分裂症病程、住院和较长的抗精神病药物治疗是非洲 APP 的相关因素。