Abstract
Background: Clozapine is the only medication licenced for patients with psychosis that
is resistant to conventional antipsychotic treatment. However, despite its effectiveness,
it remains widely underutilised. One contributory factor for this may be clinicians’ lack of
confidence around the management of clozapine.
Objective: We conducted a survey of clinicians working in Early Intervention in Psychosis (EIP)
services to determine their training needs for clozapine management in EIP services.
Methods: An electronic survey was made available to all clinicians working in EIP services in
England. The survey assessed confidence and training needs regarding managing clozapine in
patients with treatment-resistant psychosis. Quantitative data were analysed using total mean
scores and the Mann–Whitney U test.
Results: In all, 192 (27%) of approximately 700 clinicians from 35 EIP services completed
the survey. Approximately half (54%) had not received training on treatment with clozapine.
Experience of training was higher in prescribers than non-prescribers, and among medical
than non-medical clinicians. Previous training was associated with significantly higher
confidence in offering clozapine and managing treatment-resistant psychosis (p < 0.001).
Confidence levels with managing treatment-resistant psychosis and clozapine were relatively
high (mean = 4 out of 5, SD = 1). Respondents were most confident about monitoring mental
health response to treatment (mean = 5, SD = 1). Participants were least confident about
how to discontinue clozapine treatment safely (mean = 3, SD = 1).
Conclusion: Most clinicians working in EIP have not received training on the use of clozapine.
This may account, in part, for the underutilisation of clozapine in EIP services. The provision
of training in the identification of treatment-resistant psychosis and the use of clozapine will
likely improve the detection and management of treatment resistance in the early phase of
psychosis.
is resistant to conventional antipsychotic treatment. However, despite its effectiveness,
it remains widely underutilised. One contributory factor for this may be clinicians’ lack of
confidence around the management of clozapine.
Objective: We conducted a survey of clinicians working in Early Intervention in Psychosis (EIP)
services to determine their training needs for clozapine management in EIP services.
Methods: An electronic survey was made available to all clinicians working in EIP services in
England. The survey assessed confidence and training needs regarding managing clozapine in
patients with treatment-resistant psychosis. Quantitative data were analysed using total mean
scores and the Mann–Whitney U test.
Results: In all, 192 (27%) of approximately 700 clinicians from 35 EIP services completed
the survey. Approximately half (54%) had not received training on treatment with clozapine.
Experience of training was higher in prescribers than non-prescribers, and among medical
than non-medical clinicians. Previous training was associated with significantly higher
confidence in offering clozapine and managing treatment-resistant psychosis (p < 0.001).
Confidence levels with managing treatment-resistant psychosis and clozapine were relatively
high (mean = 4 out of 5, SD = 1). Respondents were most confident about monitoring mental
health response to treatment (mean = 5, SD = 1). Participants were least confident about
how to discontinue clozapine treatment safely (mean = 3, SD = 1).
Conclusion: Most clinicians working in EIP have not received training on the use of clozapine.
This may account, in part, for the underutilisation of clozapine in EIP services. The provision
of training in the identification of treatment-resistant psychosis and the use of clozapine will
likely improve the detection and management of treatment resistance in the early phase of
psychosis.
| Original language | English |
|---|---|
| Pages (from-to) | 1-7 |
| Number of pages | 7 |
| Journal | Therapeutic Advances in Psychopharmacology |
| Publication status | Published - 2022 |
