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An evaluation of the variation and underuse of clozapine in the United Kingdom

Whiskey, Eromona, Barnard, Alex, Oloyede, Ebenezer, Dzahini, Olubanke, Taylor, David M., Shergill, Sukhwinder S. (2021) An evaluation of the variation and underuse of clozapine in the United Kingdom. Acta Psychiatrica Scandinavica, 143 (4). pp. 339-347. ISSN 0001-690X. (doi:10.1111/acps.13280) (KAR id:96371)


Background: Clozapine is the only licensed treatment for treatment refractory schizophrenia. Despite this, it remains grossly underused relative to the prevalence of refractory schizophrenia. The extent of underuse and the degree of regional variation in prescribing in the United Kingdom is unknown. It is also unclear, how the UK compares with other European countries in rates of clozapine prescribing. Methods: We obtained data relating to all clozapine prescribing in the UK from the relevant clozapine registries. We examined regional variation in clozapine use across England, corrected for the known prevalence of severe mental illness (SMI). We also compared the UK rate of clozapine use per 100,000 population to that described in other European countries. Findings: There is substantial variation in clozapine prescribing across different regions of England and only about a third of potentially eligible patients were prescribed the drug in the UK. Clozapine prescribing rate in the UK was lower than in several European countries. Interpretation: There is clear regional inequity in access to the most effective treatment in refractory schizophrenia in England. Strategies to increase clozapine use, by overcoming both real and perceived barriers, are urgently necessary to reduce treatment inequity for patients with refractory schizophrenia.

Item Type: Article
DOI/Identification number: 10.1111/acps.13280
Uncontrolled keywords: clozapine, drug utilization, geography, schizophrenia, United Kingdom
Subjects: R Medicine
Divisions: Divisions > Division of Natural Sciences > Kent and Medway Medical School
Depositing User: Rachael Heller
Date Deposited: 28 Sep 2022 08:57 UTC
Last Modified: 29 Sep 2022 10:50 UTC
Resource URI: (The current URI for this page, for reference purposes)

University of Kent Author Information

Shergill, Sukhwinder S..

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