TY - JOUR
T1 - Psychiatrists’ attitude towards the use of clozapine in the treatment of refractory schizophrenia
T2 - A nationwide survey
AU - Daod, Essam
AU - Krivoy, Amir
AU - Shoval, Gal
AU - Zubedat, Salman
AU - Lally, John
AU - Vadas, Limor
AU - Weizman, Abraham
AU - Reshef, Alon
AU - Bloch, Boaz
N1 - Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/5
Y1 - 2019/5
N2 - Objectives: Clozapine is the most effective treatment for refractory schizophrenia, yet it remains underused in clinical practice. The current study examined the awareness, familiarity and attitude of a nationwide sample of Israeli psychiatrists regarding the use of clozapine. Methods: Data were collected using questionnaires, completed by 295 psychiatrists. Participants were asked to score questions regarding clozapine procedures; familiarity with guidelines, drug properties, prescription and attitude towards specialized clozapine resources. Results: About half (53.3%) of the psychiatrists reported initiating treatment with clozapine according to the guidelines, whereas 33% reported that they administered clozapine only after three or more unsuccessful antipsychotic treatments. Surprisingly, availability of specialized resources for clozapine treatment (such as clozapine clinics) was associated with delayed initiation of clozapine treatment, and a lower rate of clozapine administration. Barriers to clozapine use included concerns about patient adherence, side effects and partial compliance with the required blood monitoring. Conclusions: Delaying or avoiding clozapine treatment to potentially eligible patients, despite familiarity with the drug efficacy and treatment guidelines, is a major mental health concern. However, executive allocation of resources to support the use of clozapine may be ineffective in promoting clozapine use.
AB - Objectives: Clozapine is the most effective treatment for refractory schizophrenia, yet it remains underused in clinical practice. The current study examined the awareness, familiarity and attitude of a nationwide sample of Israeli psychiatrists regarding the use of clozapine. Methods: Data were collected using questionnaires, completed by 295 psychiatrists. Participants were asked to score questions regarding clozapine procedures; familiarity with guidelines, drug properties, prescription and attitude towards specialized clozapine resources. Results: About half (53.3%) of the psychiatrists reported initiating treatment with clozapine according to the guidelines, whereas 33% reported that they administered clozapine only after three or more unsuccessful antipsychotic treatments. Surprisingly, availability of specialized resources for clozapine treatment (such as clozapine clinics) was associated with delayed initiation of clozapine treatment, and a lower rate of clozapine administration. Barriers to clozapine use included concerns about patient adherence, side effects and partial compliance with the required blood monitoring. Conclusions: Delaying or avoiding clozapine treatment to potentially eligible patients, despite familiarity with the drug efficacy and treatment guidelines, is a major mental health concern. However, executive allocation of resources to support the use of clozapine may be ineffective in promoting clozapine use.
KW - Antipsychotics
KW - Attitudes
KW - Clozapine
KW - Knowledge
KW - Treatment-resistant schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=85063148682&partnerID=8YFLogxK
U2 - 10.1016/j.psychres.2019.03.029
DO - 10.1016/j.psychres.2019.03.029
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C2 - 30913436
AN - SCOPUS:85063148682
SN - 0165-1781
VL - 275
SP - 155
EP - 161
JO - Psychiatry Research
JF - Psychiatry Research
ER -