Rates and Reasons for Clozapine Treatment Interruptions: Impact of the Frequency of Hematologic Monitoring and Cardiac Adverse Events.

John, AP; Stanley, S; Haywood, D

Rates and Reasons for Clozapine Treatment Interruptions: Impact of the Frequency of Hematologic Monitoring and Cardiac Adverse Events.

John, AP Stanley, S Haywood, D

Permalink

Publisher:: LIPPINCOTT WILLIAMS & WILKINS
Publication Type:: Journal Article
Citation:: J Clin Psychopharmacol, 2023, 43, (3), pp. 233-238
Issue Date:: 2023-05

Closed Access

	Filename	Description	Size
	21855075_12590438530005671.pdf		181.73 kB	Adobe PDF	View/Open

Copyright Clearance Process

Recently Added
In Progress
Closed Access

This item is closed access and not available.

Full metadata record

Field	Value	Language
dc.contributor.author	John, AP
dc.contributor.author	Stanley, S
dc.contributor.author	Haywood, D https://orcid.org/0000-0002-9317-4135
dc.date.accessioned	2024-01-11T22:18:30Z
dc.date.available	2024-01-11T22:18:30Z
dc.date.issued	2023-05
dc.identifier.citation	J Clin Psychopharmacol, 2023, 43, (3), pp. 233-238
dc.identifier.issn	0271-0749
dc.identifier.issn	1533-712X
dc.identifier.uri	http://hdl.handle.net/10453/174325
dc.description.abstract	BACKGROUND: Differing rates and reasons for interruptions of clozapine treatment have been reported globally. This article evaluated the rates and reasons for clozapine therapy interruptions in Australia and explored the impact of the frequency of hematological monitoring on these parameters. METHODS: Data of the patients who were newly commenced on clozapine at three metropolitan public mental health services in Western Australia over 11 years were retrospectively collated. The rate and reasons for clozapine therapy interruptions and their association with the frequency of hematological monitoring, age, sex, and treatment site were analyzed using parametric, nonparametric, and correlational analyses. RESULTS: Of the 457 patients whose data were collected, 69.6% had an interruption of treatment with 41.2% of those occurring during the period of mandatory weekly hematological monitoring in the first 18 weeks. Nonadherence (57.4%) and adverse effects (28.8%) were the 2 main reasons for the treatment interruptions. Cardiac issues accounted for the majority of the interruptions (61.8%) due to specified adverse effects, and these occurred significantly more commonly within the first 18 weeks. Location, age, and sex did not predict the possibility of treatment interruptions. CONCLUSIONS: The high rates of clozapine treatment interruption observed during the period of weekly monitoring point toward the need to address the burden of frequent hematological monitoring for patients. Disproportionately higher rates of interruption due to cardiac adverse effects observed in this study compared with research from non-Australian settings raise the possibility of geographical differences in the adverse effects leading to treatment discontinuation.
dc.format	Print
dc.language	eng
dc.publisher	LIPPINCOTT WILLIAMS & WILKINS
dc.relation.ispartof	J Clin Psychopharmacol
dc.relation.isbasedon	10.1097/JCP.0000000000001673
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences
dc.subject.classification	Psychiatry
dc.subject.classification	32 Biomedical and clinical sciences
dc.subject.classification	42 Health sciences
dc.subject.classification	52 Psychology
dc.subject.mesh	Humans
dc.subject.mesh	Clozapine
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Antipsychotic Agents
dc.subject.mesh	Humans
dc.subject.mesh	Clozapine
dc.subject.mesh	Antipsychotic Agents
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Humans
dc.subject.mesh	Clozapine
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Antipsychotic Agents
dc.title	Rates and Reasons for Clozapine Treatment Interruptions: Impact of the Frequency of Hematologic Monitoring and Cardiac Adverse Events.
dc.type	Journal Article
utslib.citation.volume	43
utslib.location.activity	United States
utslib.for	11 Medical and Health Sciences
utslib.for	17 Psychology and Cognitive Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access	*
dc.date.updated	2024-01-11T22:18:28Z
pubs.issue	3
pubs.publication-status	Published
pubs.volume	43
utslib.citation.issue	3

Abstract:

BACKGROUND: Differing rates and reasons for interruptions of clozapine treatment have been reported globally. This article evaluated the rates and reasons for clozapine therapy interruptions in Australia and explored the impact of the frequency of hematological monitoring on these parameters. METHODS: Data of the patients who were newly commenced on clozapine at three metropolitan public mental health services in Western Australia over 11 years were retrospectively collated. The rate and reasons for clozapine therapy interruptions and their association with the frequency of hematological monitoring, age, sex, and treatment site were analyzed using parametric, nonparametric, and correlational analyses. RESULTS: Of the 457 patients whose data were collected, 69.6% had an interruption of treatment with 41.2% of those occurring during the period of mandatory weekly hematological monitoring in the first 18 weeks. Nonadherence (57.4%) and adverse effects (28.8%) were the 2 main reasons for the treatment interruptions. Cardiac issues accounted for the majority of the interruptions (61.8%) due to specified adverse effects, and these occurred significantly more commonly within the first 18 weeks. Location, age, and sex did not predict the possibility of treatment interruptions. CONCLUSIONS: The high rates of clozapine treatment interruption observed during the period of weekly monitoring point toward the need to address the burden of frequent hematological monitoring for patients. Disproportionately higher rates of interruption due to cardiac adverse effects observed in this study compared with research from non-Australian settings raise the possibility of geographical differences in the adverse effects leading to treatment discontinuation.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/174325