氯氮平使用的效用和障碍:新加坡和香港临床医生态度的联合研究。

Shushan Zheng, Jimmy Lee, S. Chan
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引用次数: 6

摘要

目的:本研究旨在调查新加坡和香港临床医生对氯氮平的态度,并阐明难治性精神分裂症患者使用氯氮平的障碍。方法:通过电子邮件邀请两地区所有精神病学临床医生参与匿名在线调查。调查收集了参与者的特征、氯氮平开始使用的经历、氯氮平的感知有用性、氯氮平开始使用的障碍以及可能改善氯氮平使用的因素。数据收集于2018年12月至2019年3月在新加坡进行,于2019年9月至2020年2月在香港进行。结果:共有261名临床医生(156名在新加坡,105名在香港)回应了调查。大多数参与者认为氯氮平是一种有效且令人满意的治疗精神分裂症的方法。临床医生最关心的是需要频繁的血液监测(84.5%在新加坡;香港87.5%),氯氮平耐受性(新加坡51.9%;香港为61.6%),以及医疗并发症(新加坡为54.8%;香港(49.1%)。与香港相比,新加坡更多的临床医生认为氯氮平使用不足(67.9%;(香港占51.4%),以及在诊所和行政支援方面对门诊资源的更大需求(新加坡占74.4%;(香港占59.0%)改善氯氮平处方。结论:氯氮平对难治性精神分裂症的利用不足在这两个地区仍然是一个值得关注的问题。一个综合氯氮平服务,解决系统障碍和临床医生对氯氮平处方和管理其不良反应的信心,将大大提高氯氮平的利用率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Utility and Barriers to Clozapine Use: A Joint Study of Clinicians' Attitudes From Singapore and Hong Kong.
Objective: This study aimed to survey clinicians' attitudes in Singapore and Hong Kong toward clozapine and elucidate the barriers to its prescription in patients with treatment-resistant schizophrenia. Methods: All clinicians in psychiatry in both regions were invited through email to participate in an anonymous online survey. The survey collected information on the participants' characteristics, their experience with clozapine initiation, perceived usefulness of clozapine, barriers to clozapine initiation, and factors that might improve clozapine use. Data collection took place between December 2018 and March 2019 in Singapore and September 2019 and February 2020 in Hong Kong. Results: A total of 261 clinicians (156 in Singapore, 105 in Hong Kong) responded to the survey. The majority of participants believed that clozapine was an effective and satisfactory treatment for schizophrenia. Clinicians were most concerned about the need for frequent blood monitoring (84.5% in Singapore; 87.5% in Hong Kong), clozapine's tolerability (51.9% in Singapore; 61.6% in Hong Kong), and medical complications (54.8% in Singapore; 49.1% in Hong Kong). Compared to Hong Kong, more clinicians in Singapore endorsed an underutilization of clozapine (67.9% in Singapore; 51.4% in Hong Kong) and a greater need for outpatient resources in terms of clinic and administrative support (74.4% in Singapore; 59.0% in Hong Kong) to improve clozapine prescription. Conclusions: The underutilization of clozapine in treatment-resistant schizophrenia remains a concern in both regions. An integrated clozapine service that addresses the system barriers and clinicians' confidence in prescribing clozapine and managing its adverse effects would greatly improve the utilization of clozapine.
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