Yasui-Furukori, Norio Dokkyo Medical University
Muraoka, Hiroyuki Tokyo Women's Medical University
Hasegawa, Naomi National Center of Neurology and Psychiatry
Ochi, Shinichiro Ehime University
Hori, Hikaru Fukuoka University
Hishimoto, Akitoyo Yokohama City University
Onitsuka, Toshiaki Kyushu University
Ohi, Kazutaka Gifu University
Hashimoto, Naoki Hokkaido University
Nagasawa, Tatsuya Kanazawa Medical University
Takaesu, Yoshikazu University of the Ryukyus
Inagaki, Takahiko Biwako Hospital
Tagata, Hiromi Toho University
Tsuboi, Takashi Kyorin University
Kubota, Chika National Center of Neurology and Psychiatry
Furihata, Ryuji Kyoto University
飯田, 仁 Tokushima University
Miura, Kenichiro National Center of Neurology and Psychiatry
Matsumoto, Junya National Center of Neurology and Psychiatry
Yamada, Hisashi Hyogo College of Medicine
Watanabe, Koichiro Kyorin University
Inada, Ken Tokyo Women's Medical University
Shimoda, Kazutaka Dokkyo Medical University
Hashimoto, Ryota National Center of Neurology and Psychiatry
Background: The decision to initiate clozapine treatment should be made on an individual basis and may be closely related to the early detection of treatment-resistant schizophrenia (TRS), although there is evidence that the early use of clozapine results in a better response to treatment. Therefore, we investigated the relationship between the examination rate of TRS and the prescription rate of clozapine.
Methods: After attending a 1-day educational program on schizophrenia based on the "Guidelines for the Pharmacological Treatment of Schizophrenia," we asked the participating facilities to submit records of whether or not TRS was evaluated for each patient. We calculated the clozapine prescription rate from the schizophrenic patients prescribed clozapine and all of the schizophrenic patients. Forty-nine facilities in 2017 were included in the study.
Results: There were dichotomous distributions in the examination rate of TRS and a non-normal distribution in the prescription rate of clozapine. There was a significant correlation between the prescription rate of clozapine and the examination rate of TRS (r s = 0.531, P = 1.032 × 10−4). A significant difference was found in the prescription rate of clozapine between the three groups of facilities according to the examination rate of TRS.
Conclusion: As a preliminary problem for the use of clozapine, in Japan, the examination rate of TRS varies, and there are many facilities that typically do not consider the possibility of TRS; this trend leads to a low rate of clozapine use. Clearly, further clinician training is needed for the early detection and appropriate management of TRS that includes an explanation of TRS and how to introduce clozapine therapy to patients and their families.
The Japanese Society of Neuropsychopharmacology|John Wiley & Sons
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