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Clozapine: national review of postcode prescribing

  • Johnny Downs (a1) and Martin Zinkler (a2)
Abstract
Aims and Method

We review the prescribing rates for clozapine among all mental health trusts in England and explore whether it has changed with the introduction of NICE guidelines, generic clozapine and the Healthcare Commission ratings. Data were collected from mental health trusts in 2005–2006 and compared with a previous study from 2000. Mental health star ratings of 2004–2005 were taken from the Healthcare Commission.

Results

We found a reduced inter-trust variability from 34-fold variation in 2000 to 5-fold variation in 2005–2006. There was a significant inverse relationship between star rating and clozapine prescribing.

Clinical Implications

NICE guidelines and generic clozapine seem to have improved access to gold standard therapy for treatment-resistant schizophrenia. Star ratings have little bearing on the implementation of NICE guidelines.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Alvir, J. M., Lieberman, J. A., Safferman, A. Z., et al (1993) Clozapine-induced agranulocytosis. Incidence and risk factors in the United States. New England Journal of Medicine, 329, 162167.
Glover, G. (1998) A needs index for mental health care. Social Psychiatry and Psychiatric Epidemiology, 88, 8996.
Hayhurst, K. P., Brown, P. & Lewis, S.W. (2003) Postcode prescribing for schizophrenia. British Journal of Psychiatry, 182, 281283.
Healthcare Commission (2005) Mental Health Trust Performance Indicators. http://www.healthcarecommission.org.uk/_db/_documents/04018745.pdf
National Institute for Clinical Excellence (2002) Guidance on the Use of New (Atypical) Antipsychotic Drugs for the Treatment of Schizophrenia (Technology Appraisal Guidance 43). NICE.
Office for National Statistics (2001) KS01 Usual Resident Population: Census 2001. http://www.statistics.gov.uk/StatBase/Expodata/Spreadsheets/D894.xls
Purcell, H. & Lewis, S. (2000) Postcode prescribing in psychiatry: clozapine in an English county. Psychiatric Bulletin, 24, 420422.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Clozapine: national review of postcode prescribing

  • Johnny Downs (a1) and Martin Zinkler (a2)
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