Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.
BMC Psychiatry. 2022 Aug 6;22(1):534. doi: 10.1186/s12888-022-04179-5.
Clozapine has the greatest efficacy for treatment-resistant schizophrenia (TRS), even though its underutilization is not uncommon across different countries. This study aimed to investigate the knowledge and attitude of Iranian psychiatrists toward clozapine use.
In this cross-sectional study, a questionnaire was distributed among psychiatrists registered with the Iranian Psychiatrists Association (including its provincial branches) to assess their knowledge and attitude towards clozapine use. A total of 282 psychiatrists completed the questionnaire. Descriptive analysis was used to describe demographic information, and Chi-square tests were conducted to determine if there is an association between academic position and work experience. All statistical analyses were performed using SPSS® version 25.0 for Windows, and a significance level of 0.05 was used.
Most respondents (93%) acknowledged that they prescribed clozapine for their patients, and 74% believed that clozapine was more effective than other antipsychotic drugs. However, 43.3% of the respondents said they did not believe in the safety of clozapine. Difficulty initiating and having no firsthand experience in the superiority of clozapine were reported by 81.2 and 80% of the respondents, respectively. Our results also showed an association between having an academic position and access to appropriate facilities for the control and management of patients treated with clozapine and believing in the safety of clozapine (p < 0.05). Longer work experience (more than 15 years) was associated with a higher prescription of clozapine, belief in greater effectiveness of clozapine, and its safety (p < 0.0001).
Iranian psychiatrists had a good self-perception of knowledge about the efficacy of clozapine for patients with TRS, but concerns about serious side effects are common. Psychiatrists with longer work experience and academic positions were more optimistic towards clozapine use than the younger ones with no academic position. Considering the results in planning the strategies to decrease concerns about clozapine use is recommended.
氯氮平对于治疗抵抗性精神分裂症（TRS）最有效，尽管在不同国家都存在其使用不足的情况。本研究旨在调查伊朗精神科医生对氯氮平使用的认知和态度。
在这项横断面研究中，向伊朗精神病医生协会（包括其省级分会）注册的精神科医生发放问卷，以评估他们对氯氮平使用的认知和态度。共有 282 名精神科医生完成了问卷。使用描述性分析来描述人口统计学信息，并进行卡方检验以确定学术地位和工作经验之间是否存在关联。所有统计分析均使用 Windows 版 SPSS® 25.0 进行，显著性水平设为 0.05。
大多数受访者（93%）承认他们为患者开氯氮平，74%的人认为氯氮平比其他抗精神病药物更有效。然而，43.3%的受访者表示他们不相信氯氮平的安全性。81.2%和 80%的受访者分别表示他们在启动氯氮平和缺乏氯氮平优越性的第一手经验方面存在困难。我们的结果还表明，拥有学术地位和获得适当设施来控制和管理接受氯氮平治疗的患者与相信氯氮平的安全性之间存在关联（p<0.05）。工作经验更长（超过 15 年）与氯氮平的更高处方、更大疗效的信念和安全性相关（p<0.0001）。
伊朗精神科医生对氯氮平治疗 TRS 患者的疗效有较好的自我认知，但对严重副作用的担忧很常见。工作经验更长和拥有学术地位的精神科医生比没有学术地位的年轻医生对氯氮平的使用更为乐观。建议在制定减少对氯氮平使用的担忧的策略时考虑这些结果。
