Early access to clozapine in early intervention in psychosis: hope versus reality. A mixed method service analysis
| Autor: | Richard Whale, Katherine Hill, Nikola Nikolić, Vijitha Wickramasinghe, Emogen Campbell |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Olanzapine
medicine.medical_specialty Psychosis Younger age medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine medicine Humans Psychiatry Antipsychotic Clozapine Biological Psychiatry First episode Service (business) business.industry medicine.disease 030227 psychiatry Early intervention in psychosis Psychiatry and Mental health Cross-Sectional Studies Psychotic Disorders Schizophrenia Pshychiatric Mental Health business 030217 neurology & neurosurgery Antipsychotic Agents medicine.drug |
| ISSN: | 1751-7885 |
| Popis: | Aim: Improving access to clozapine is a recognised priority nationally across Early Intervention in Psychosis Services (EIPS) in the UK. Treatment resistance (TR) may be identifiable from early episode psychosis and appears to be characterized by negative symptoms and younger age of onset. This mixed method cross sectional snapshot analysis of antipsychotic prescribing in an EIPS, explored clozapine eligibility (CE), and prioritisation of antipsychotic prescribing based on choice, selectivity and appropriateness. \ud Method: We screened 150 service users and 79% (n=119) were retained after inclusion criteria were applied. We explored CE in all service users who were indicated clozapine based on the product licence (n=78), and whether there was association between CE and number of hospital admissions, antipsychotic trials, age at first episode and duration of untreated psychosis.\ud Results: Following multidisciplinary clinical discussions, we found that 23 service users were CE; 8 were offered and declined clozapine. When compared to non-CE service users, significant factors associated with CE were history of 2 or more hospital admissions (Mann-Whitney U=269, p=0.008), more than 2 trials of 2 different antipsychotics (Mann-Whitney U=517, p= |
| Databáze: | OpenAIRE |
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