Hayhurst K P, Brown P, Lewis S W
School of Psychiatry and Behavioural Sciences, University of Manchester, Wythenshawe Hospital, UK.
J Psychopharmacol. 2002 Jun;16(2):169-75. doi: 10.1177/026988110201600208.
A retrospective cohort study, with a mirror-image design, was used to measure inpatient service utilization in 63 consecutive patients started on clozapine from a geographical catchment area compared to a control group matched for previous inpatient service use. An intent-to-treat analysis, including those patients (n = 28) who discontinued clozapine during the study period, showed a significant reduction in number of admissions and total time spent in hospital in the 2 years following clozapine initiation compared to the previous 2 years and to the follow-up period in the control group. This translated into a reduction of 7,300 pounds in hospitalization costs per patient started on clozapine, over the 2-year period. In those patients who continued clozapine treatment for the whole of the 2-year period, there was a two-thirds reduction in number of admissions and total time spent in hospital compared to no change in the clozapine discontinuers. These findings suggest that clozapine is a clinically and cost-effective intervention for severe schizophrenia in routine clinical settings.
一项采用镜像设计的回顾性队列研究，用于衡量来自某地理区域的63例连续开始使用氯氮平的住院患者的住院服务利用率，并与在既往住院服务使用情况上相匹配的对照组进行比较。意向性分析包括那些在研究期间停用氯氮平的患者（n = 28），结果显示，与前两年以及对照组的随访期相比，氯氮平起始治疗后的2年里，住院次数和总住院时间显著减少。这意味着在2年期间，每例开始使用氯氮平的患者的住院费用减少了7300英镑。在整个2年期间持续接受氯氮平治疗的患者中，与停用氯氮平的患者无变化相比，住院次数和总住院时间减少了三分之二。这些发现表明，在常规临床环境中，氯氮平是治疗重度精神分裂症的一种具有临床疗效和成本效益的干预措施。
