| Autor: |
Koole, M. I., Roelofsen, E. E., Baptist, E., Van Der Meer, R., Wilms, E. B., Visser, L. E. |
| Přispěvatelé: |
Pharmacy |
| Jazyk: |
Dutch; Flemish |
| Rok vydání: |
2019 |
| Zdroj: |
Pharmaceutisch Weekblad, 154(29-30), 27-32. Kon. Ned. Mij. ter Bevordering der Pharmacie (KNMP) |
| ISSN: |
0031-6911 |
| Popis: |
BACKGROUND Hospitalized patients on clozapine are at risk for dysregulation of their clozapine blood concentration due to smoking cessation, (pre-existing) infections and the use of drugs which influence the metabolism of clozapine. In July 2017 a therapeutic guideline was implemented in the Haga Teaching Hospital and Haaglanden Medical Centre to monitor patients during hospital admission to prevent clozapine toxicity. OBJECTIVE Primary objective was to study the effect of the guideline by comparing the percentage of hospitalized patients with one or more serum clozapine levels > 0.80 mg/L and/or > 50% increase of their serum clozapine level during admission, before and after implementation of the guideline. DESIGN We conducted a non-interventional retrospective study. METHODS In a period of ten months before and after the implementation of the guideline, data from all hospitalized patients 18 years using clozapine for schizophrenia were collected from electronic patient files. RESULTS In90%ofallpatientsaninterventionwasnecessaryaccording to the guideline. There was no significant difference between the percentage of patients with supratherapeutic clozapine levels before and after the implementation of the guideline (P = 0.695). The involvement of the hospital pharmacist improved significantly after implementation of the therapeutic guideline (number of interventions; P < 0,001). The hospital pharmacist recommended the involvement/consultation of the psychiatrist in 39% of the admissions after implementation of the guideline. CONCLUSION The therapeutic guideline did not reduce the number of patients with supratherapeutic clozapine levels. However, the involvement of the hospital pharmacist resulted in earlier involvement of the psychiatrist. According to the guideline an intervention was necessary in most patients 190%). All patients with supratherapeutic clozapine levels (n = 28) had an infection and/or an elevated CRP which suggests early dose reductions are required. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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