Clozapine is an effective antipsychotic used in treatment-resistant schizophrenia.1 It is considered a last and best option for patients who have responded to, or tolerated, little else.2 We know that patient knowledge of medication is positively correlated to adherence and hence health outcomes3 and that pharmacists represent an accessible health professional uniquely qualified to deliver key information and counselling to patients. 4
To improve knowledge amongst schizophrenic patients receiving clozapine through a pharmacist intervention.
Materials and Methods
All patients receiving clozapine in the Mercy University Hospital (MUH) were eligible for inclusion unless they were deemed to be clinically too unwell. A questionnaire was designed and administered, by a clinical pharmacist, assessing clozapine knowledge. Questions included: ¿Do you know why you need to have regular blood tests?¿ Patients were scored out of 13. A pharmacist-developed patient information leaflet (PIL) on clozapine was provided to all of the participants in addition to advice and counselling on clozapine treatment. Patients were reassessed to determine whether the intervention had improved their knowledge on clozapine. The Statistical package for the Social Sciences (SPSS) Version 15 was used for data analysis. Descriptive statistics include frequencies, percentages and mean values. Means are reported with standard deviation (SD) where appropriate. Bivariate analyses were conducted to determine any statistically significant relationships between varying parameters. Paired samples T-test is used to describe the correlation between the scores obtained at first and second interviews.
Results and Conclusions
Forty four patients (66% male, 70% smokers, 95% unemployed) took part in the study. The average age of the population was found to be 39 years (±11.6). The average score in the questionnaire pre-intervention was 8.16 which increased to an average of 9.57 post intervention. This improvement was statistically significant (p<0.001).
The pharmacist¿s intervention led to improved knowledge amongst schizophrenic patients on clozapine.
- Wahlbeck K, Cheine M, Essali A, Adams C. Evidence of Clozapine¿s Effectiveness in Schizophrenia: A Systematic Review and Meta-Analysis of Randomized Trials. American Journal of Psychiatry 1999; 156:990-999.
- Sandson NB, Cozza KL, Armstrong SC, Eckermann G, Fischer BA, Philips B. Med-Psych Drug-Drug Interactions Update - Clozapine Case Series. Psychosomatics 2007; 48:170-175.
- Kay SR, Fiszbein A, Opler LA. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin 1987; 13:261¿276.
- American College of Clinical Pharmacy (ACCP). The Definition of Clinical Pharmacy. Pharmacotherapy 2008; 28(6):816-817.