A National Analysis of Facility-Level Clozapine Availability in U.S. Mental Health Services.

IF 3.2

Psychiatric services (Washington, D.C.) Pub Date : 2025-09-30 DOI:10.1176/appi.ps.20250098

Samuel R Bunting, Aparna Das, Luca Iacobelli, Emily Griner, Beth Broussard, Robert O Cotes

{"title":"A National Analysis of Facility-Level Clozapine Availability in U.S. Mental Health Services.","authors":"Samuel R Bunting, Aparna Das, Luca Iacobelli, Emily Griner, Beth Broussard, Robert O Cotes","doi":"10.1176/appi.ps.20250098","DOIUrl":null,"url":null,"abstract":"Objective: Clozapine is highly effective but underutilized because of patient-, prescriber-, and system-related factors. The purpose of this study was to describe clozapine availability at U.S. mental health facilities.Methods: A cross-sectional analysis of the 2023 National Substance Use and Mental Health Services Survey was conducted. Clozapine availability was assessed along with facility characteristics associated with odds of clozapine prescription via logistic regression.Results: Among facilities that prescribed antipsychotics (N=6,445), clozapine was available at 58% overall and at 64% that had a dedicated serious mental illness program. Psychiatric hospitals had the highest availability (80%). Outpatient facilities (adjusted odds ratio [AOR]=0.41, p=0.004) were less likely to offer clozapine, and those with serious mental illness programs (AOR=1.57, p<0.001), those with on-site laboratory testing (AOR=1.69, p<0.001), and those that accepted Medicare (AOR=1.92, p<0.001) were more likely to offer it.Conclusions: Limited facility-wide clozapine availability in many settings underscores the depth of its underutilization. Closing gaps in clozapine access will require targeted policy, quality improvement, and educational initiatives.","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20250098"},"PeriodicalIF":3.2000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psychiatric services (Washington, D.C.)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1176/appi.ps.20250098","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: Clozapine is highly effective but underutilized because of patient-, prescriber-, and system-related factors. The purpose of this study was to describe clozapine availability at U.S. mental health facilities.

Methods: A cross-sectional analysis of the 2023 National Substance Use and Mental Health Services Survey was conducted. Clozapine availability was assessed along with facility characteristics associated with odds of clozapine prescription via logistic regression.

Results: Among facilities that prescribed antipsychotics (N=6,445), clozapine was available at 58% overall and at 64% that had a dedicated serious mental illness program. Psychiatric hospitals had the highest availability (80%). Outpatient facilities (adjusted odds ratio [AOR]=0.41, p=0.004) were less likely to offer clozapine, and those with serious mental illness programs (AOR=1.57, p<0.001), those with on-site laboratory testing (AOR=1.69, p<0.001), and those that accepted Medicare (AOR=1.92, p<0.001) were more likely to offer it.

Conclusions: Limited facility-wide clozapine availability in many settings underscores the depth of its underutilization. Closing gaps in clozapine access will require targeted policy, quality improvement, and educational initiatives.

查看原文本刊更多论文

美国精神卫生服务机构氯氮平可用性的全国分析

目的：氯氮平是一种高效的药物，但由于患者、处方者和系统相关因素的影响，氯氮平未得到充分利用。本研究的目的是描述氯氮平在美国精神卫生机构的可用性。方法：对《2023年全国物质使用和精神卫生服务调查》进行横断面分析。通过逻辑回归评估氯氮平的可用性以及与氯氮平处方几率相关的设施特征。结果：在处方抗精神病药物的机构（N=6,445）中，氯氮平在总体上占58%，在专门的严重精神疾病项目中占64%。精神病院的可用性最高（80%）。门诊机构（调整优势比[AOR]=0.41, p=0.004）提供氯氮平的可能性较小，而那些有严重精神疾病项目的机构（AOR=1.57, p）提供氯氮平的可能性较小。缩小氯氮平获取方面的差距需要有针对性的政策、质量改进和教育举措。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Psychiatric services (Washington, D.C.)

自引率

0.00%

发文量