Srour Ahmad, Eltorki Yassin, Malik Humayun, Alabdulla Majid A, Hassan Mohamed H M O, Ahmed Al Subaiey Maha, Michael Haddad Peter
Department of Psychiatry, Hamad Medical Corporation, Qatar.
College of Pharmacy, Qatar University, Qatar.
Saudi Pharm J. 2023 Feb;31(2):214-221. doi: 10.1016/j.jsps.2022.12.005. Epub 2022 Dec 16.
Subjective views of clozapine treatment among patients with schizophrenia in the Middle East and North African MENA Region have not previously been assessed. Globally, few studies have assessed the views of carers to clozapine treatment. We conducted a cross-sectional survey, using a clinician administered structured interview, of patients with schizophrenia/schizoaffective disorder prescribed clozapine in Qatar, and their primary carers. Participants were asked to rate clozapine against prior their antipsychotic treatment in terms of specific benefits and side effects. Forty-two patients and 33 carers participated in the study. Of the patients, two thirds were male, approximately half were Qatari and the mean age was 33.9 years. Patients and carers rated clozapine as superior to prior antipsychotic treatment on all 7 potential benefits inquired about. The greatest perceived benefit was improved mood. Patients rated clozapine as less likely to cause extrapyramidal side effects but more likely to cause 18 other potential side effects compared to prior antipsychotic treatment, with the greatest difference being for nocturnal salivation, increased appetite, and constipation Nearly half of patients (48 %) and two thirds of carers (64 %) stated that they would have preferred to start clozapine earlier in their illness. Sixty percent of patients and 37 % of carers regarded the information that they had received from health professionals on clozapine as inadequate. Less than half of patients and approximately-two thirds of carers had adequate knowledge of haematological monitoring for clozapine. Generally, there were significantly positive correlation between patients and carers regarding the overall side effects of clozapine treatment. Likewise, improvement in hearing voices paranoid thoughts correlated with improved quality of life. In summary, the results show that patients and carers appreciate the benefits of clozapine despite its side effects being problematic. The results support clozapine being offered earlier in treatment and services providing more information on clozapine to patients and carers.
此前尚未评估中东和北非地区（MENA）精神分裂症患者对氯氮平治疗的主观看法。在全球范围内，很少有研究评估护理人员对氯氮平治疗的看法。我们在卡塔尔对开具氯氮平处方的精神分裂症/分裂情感性障碍患者及其主要护理人员进行了一项横断面调查，采用临床医生实施的结构化访谈。参与者被要求根据特定益处和副作用，将氯氮平与之前的抗精神病药物治疗进行评分。42名患者和33名护理人员参与了该研究。患者中，三分之二为男性，约一半为卡塔尔人，平均年龄为33.9岁。患者和护理人员认为氯氮平在所有询问的7项潜在益处方面均优于之前的抗精神病药物治疗。最大的感知益处是情绪改善。与之前的抗精神病药物治疗相比，患者认为氯氮平引起锥体外系副作用的可能性较小，但引起其他18种潜在副作用的可能性较大，最大差异在于夜间流涎、食欲增加和便秘。近一半的患者（48%）和三分之二的护理人员（64%）表示，他们希望在疾病早期就开始使用氯氮平。60%的患者和37%的护理人员认为他们从医疗专业人员那里获得的关于氯氮平的信息不足。不到一半的患者和约三分之二的护理人员对氯氮平血液学监测有足够的了解。总体而言，患者和护理人员在氯氮平治疗的总体副作用方面存在显著正相关。同样，幻听偏执观念的改善与生活质量的提高相关。总之，结果表明，尽管氯氮平有副作用问题，但患者和护理人员认可其益处。结果支持在治疗早期提供氯氮平，并支持服务机构向患者和护理人员提供更多关于氯氮平的信息。
