Translation and cross-cultural adaption of an instrument measuring patient's well-being under treatment for schizophrenia.

OBJECTIVES: The Subjective Well-Being under Neuroleptic (SWN) Scale is a self-rating scale measuring the well-being of patients with schizophrenia under antipsychotic drug treatment. The instrument has been globally used, with issues regarding the well-being assessment scale across different cultures, patient characteristics, and country-setting remains a controversy. This study aimed to translate and culturally adapt the SWN scale into the Indonesian version (Indonesian Modified SWN or IM-SWN) and evaluate its validity and reliability. METHODS: The SWN instrument was translated and culturally adapted following internationally accepted procedures, including forward translation, expert panel review, backward-translation, pretesting and cognitive interviewing, and psychometric analysis for the final version of the scale. The translated instrument was tested on 108 schizophrenia patients. The instrument's validity and reliability were assessed using Pearson's correlation and Cronbach's Alpha coefficient. Additional analysis for the socio-demographic and psychometric properties of the patient was also conducted. RESULTS: The range of IM-SWN total score between 30 and 112. IM-SWN was found to have a high-reliability coefficient (0.897), and the internal consistency values of each question item ranged between 0.885 and 0.910. The results also showed a high correlation between five order factors (Physical functioning, mental functioning, self-control, emotional regulation, and social integration), with a total score of between 0.768 and 0.885. CONCLUSIONS: This study highlighted that the IM-SWN is a valid and reliable instrument for measuring well-being among the Indonesian population with schizophrenia.

The prescription patterns of second-generation antipsychotics in schizophrenia outpatient setting.

Background Schizophrenia is a chronic disorder that requires long-term treatment to achieve symptom remission and quality of life improvement. Antipsychotic medications are primary treatments for schizophrenia patients. Second-generation antipsychotics (SGAs) have been recognized as first-line drugs in the treatment of schizophrenia. This study aimed at determining the prescription patterns of SGAs in schizophrenia outpatients in the National Mental Hospital in Indonesia. Methods A retrospective study with descriptive analysis was conducted between October and December 2018, exclusive to data of the patients with schizophrenia only. Data were collected from the prescription records of schizophrenia outpatients. This study performed a descriptive analysis of patient characteristics, percentage of SGAs prescribed, regimen doses of SGAs, average number of SGAs prescribed per patient, and pattern of antipsychotics prescribed. Results The most commonly used SGAs were risperidone 55%, followed by clozapine 38%, aripiprazole 3%, quetiapine 3%, and olanzapine 1%. Antipsychotics were generally prescribed in their recommended doses. Almost all SGAs were prescribed as polypharmacy, and the most common combination of SGAs were risperidone and clozapine. Conclusions This study highlighted that risperidone was the major choice for treatment in the outpatient setting. Polypharmacy is the most common pattern prescription of SGAs in the National Mental Hospital in Indonesia. New studies should focus on the analyses of polypharmacy prospectively, and the role of pharmacist in collaboration with other health professionals in the managing of schizophrenia therapy.