A Chart Audit Study of Clozapine Utilization in Early Psychosis
| Autor: | Marie-France Demers, Isabelle Bilodeau, Louis-David Leclerc, Phil Tibbo, Andrea Bardell, Marc-André Roy, Richard V. Williams |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Psychosis Pediatrics medicine.medical_specialty Canada Time Factors Adolescent medicine.medical_treatment media_common.quotation_subject Severity of Illness Index 03 medical and health sciences Young Adult 0302 clinical medicine Intervention (counseling) Severity of illness medicine Personality Humans Pharmacology (medical) Antipsychotic Clozapine media_common Retrospective Studies Psychiatric Status Rating Scales business.industry Remission Induction medicine.disease 030227 psychiatry Substance abuse Psychiatry and Mental health Psychotic Disorders Clinical Global Impression Female business 030217 neurology & neurosurgery medicine.drug Antipsychotic Agents |
| Zdroj: | Journal of clinical psychopharmacology. 41(3) |
| ISSN: | 1533-712X |
| Popis: | Purpose This study aimed to document the treatment trajectories and clozapine use in first-episode psychosis patients and to document the underlying reasons for using or not using clozapine in patients not achieving psychosis remission. Methods We conducted a retrospective chart audit of patients aged 18 to 30 years having DSM-5 diagnoses of schizophrenia spectrum psychotic disorders treated in 3 Canadian early intervention programs for psychosis. The severity of the patient's illness (using the Clinical Global Impression Severity [CGI-S] scale) and remission of psychosis were rated before and after each antipsychotic trial. Results One hundred and forty-seven patients were included in the study. There were 19.7% patients exposed to clozapine after an average of 2.4 antipsychotic trials and a mean delay of 470.8 days. There were 75.9% patients who improved their CGI-S score (mean improvement, 2.5) after the clozapine trial and 62.1% achieved a CGI-S score ≤3. Full remission of psychosis on clozapine was achieved in 69.0% of the patients. Clozapine was successfully used for some patients with a nonadherent profile in our sample (eg, personality disorder, substance use disorder). Although the mean duration of clozapine trials during the observation period was 688.6 days, no patient discontinued clozapine because of adherence issues. Conclusions Clozapine use in these early intervention programs were at a rate consistent to what is expected from the literature and allowed a majority of patients to achieve remission of psychosis and to experience a robust improvement of severity of illness. |
| Databáze: | OpenAIRE |
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