Hornsby Ku-ring-gai Hospital, North Sydney Local Health District, Hornsby, NSW, Australia.
Psychiatric Rehabilitation Service, Hunter New England Mental Health, Morisset, NSW, Australia; and School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Callaghan, NSW, Australia.
Australas Psychiatry. 2024 Apr;32(2):147-150. doi: 10.1177/10398562231177824. Epub 2023 May 31.
To elicit mental health clinicians' views on the reasons for delayed initiation of clozapine treatment.
Thematic analysis of transcripts from a semi-structured interview of 15 mental health clinicians.
Four major themes emerged from data analysis: Patient and Carer Factors, Medication factors, Protocol factors, and Prescriber factors. Patient and carer anxiety over side effects and experience of stigma, difficulties in implementing the monitoring protocol, problems with community managing of treatment, prescriber preferences and practices, and gaps in mental health services were some of the reasons identified.
Education and support to patients and carers, a modified monitoring protocol, establishing clozapine clinics, improved early intervention services, and upskilling of clinicians can promote early clozapine initiation.
了解精神卫生临床医生对氯氮平治疗延迟启动的原因的看法。
对 15 名精神卫生临床医生进行半结构化访谈的转录本进行主题分析。
数据分析中出现了四个主要主题：患者和照顾者因素、药物因素、方案因素和处方者因素。患者和照顾者对副作用和污名化经历的焦虑、实施监测方案的困难、社区管理治疗的问题、处方者的偏好和做法以及精神卫生服务的差距等是确定的一些原因。
对患者和照顾者进行教育和支持，修改监测方案，建立氯氮平诊所，改善早期干预服务，以及提高临床医生的技能，可以促进早期启动氯氮平治疗。
