[Stabilized clozapine users: specialized health care recommended].

Abstract

Background: In the current health care landscape, efforts are being made to identify the best treatment setting for ‘stable clozapine users’ when they no longer require intensive multidisciplinary outpatient treatment, such as a FACT team. Knowledge about their prognosis is essential for this.

Aim: The aim of this research is to gain insight into treatment that stable clozapine users receive within a specially established clozapine outpatient clinic. This understanding will help formulate recommendations regarding the organization of care for this group.

Method: A retrospective analysis of medical records and data was conducted on a group of patients defined as ‘stable clozapine users’ who were being treated at the clozapine outpatient clinic.

Results: A total of 62 patients were treated at the clozapine outpatient clinic; 60 were included in our study. Of these, 77% required more treatment than initially estimated, indicating an underestimation of their care needs. Intensive treatment was provided to 60% of the patients, and 33% of them experienced a one-time or repeated escalation of care. Additionally, 15% of the patients were admitted to a hospital at least once. Notably, 23% of the patients were (re)referred to a FACT team.

Conclusion: The findings indicate that stable clozapine users remain vulnerable, and most patients will require intensive treatment again at some point. To prevent discontinuity of treatment, we recommend keeping stabilized patients with psychosis under treatment in specialized mental health care teams, rather than referring them back to primary care.