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Tytuł:
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What about regular hematological monitoring during clozapine treatment? A compliance analysis using the French health insurance database.
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Autorzy:
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Laforgue EJ; Clinical Pharmacology Department, Nantes University Hospital, Nantes, France.; INSERM UMR 1246 SPHERE (Methods in Patients-centered Outcomes and HEalth Research), Nantes and Tours Universities, France.
Istvan M; Clinical Pharmacology Department, Nantes University Hospital, Nantes, France.; INSERM UMR 1246 SPHERE (Methods in Patients-centered Outcomes and HEalth Research), Nantes and Tours Universities, France.
Guerlais M; Clinical Pharmacology Department, Nantes University Hospital, Nantes, France.
Chaslerie A; Medical Department, French Health Insurance System, Nantes, France.
Artarit P; Medical Department, French Health Insurance System, Nantes, France.
Vallot G; Medical Department, French Health Insurance System, Nantes, France.
Jolliet P; Clinical Pharmacology Department, Nantes University Hospital, Nantes, France.; INSERM UMR 1246 SPHERE (Methods in Patients-centered Outcomes and HEalth Research), Nantes and Tours Universities, France.
Grall-Bronnec M; INSERM UMR 1246 SPHERE (Methods in Patients-centered Outcomes and HEalth Research), Nantes and Tours Universities, France.; Addictology and Liaison-Psychiatry Department, Nantes University Hospital, Nantes, France.
Victorri-Vigneau C; Clinical Pharmacology Department, Nantes University Hospital, Nantes, France.; INSERM UMR 1246 SPHERE (Methods in Patients-centered Outcomes and HEalth Research), Nantes and Tours Universities, France.
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Źródło:
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Expert opinion on drug safety [Expert Opin Drug Saf] 2021 Oct; Vol. 20 (10), pp. 1247-1256. Date of Electronic Publication: 2021 Jun 14.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: 2015- : Abingdon, Oxford : Taylor & Francis
Original Publication: London : Ashley Publications, c2002-
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MeSH Terms:
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Agranulocytosis/*diagnosis
Antipsychotic Agents/*adverse effects
Clozapine/*adverse effects
Drug Monitoring/*methods
Agranulocytosis/chemically induced ; Antipsychotic Agents/administration & dosage ; Clozapine/administration & dosage ; Databases, Factual ; Female ; France ; Guideline Adherence ; Hospitalization/statistics & numerical data ; Humans ; Insurance, Health ; Leukocyte Count ; Male ; Middle Aged ; Schizophrenia/drug therapy
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Contributed Indexing:
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Keywords: Clozapine; Parkinson’s disease; health insurance database; schizoaffective disorder; schizophrenia
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Substance Nomenclature:
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0 (Antipsychotic Agents)
J60AR2IKIC (Clozapine)
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Entry Date(s):
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Date Created: 20210604 Date Completed: 20211007 Latest Revision: 20220426
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Update Code:
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20240105
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DOI:
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10.1080/14740338.2021.1939304
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PMID:
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34085879
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Background: The inherent risk of agranulocytosis associated with clozapine requires the realization of weekly white blood cell monitoring (WBCM) during the 18 first weeks of treatment. The aim of this study was to assess the compliance with WBCM during clozapine initiation for schizophrenia and Parkinson's disease (PD) subjects.
Research Design and Method: The analysis was conducted using SNDS data on a cohort of new users of clozapine in 2018. We analyzed all reimbursements for WBCM from 2 weeks before the index date to 18 weeks after (optimal monitoring during hospitalization was assumed). The primary outcome was the proportion of good realization of WBCM according to different thresholds of completion (70%; 80%; 90%). Descriptive and comparative analyses with chi-squared test or Student's t-test were performed.
Results: Two hundred and ninety-six subjects were included. Rates of patients with WBCM realization over 70%, 80%, and 90% of WBCM expected were, respectively, 78.1%, 70.0%, and 56.9% for subjects with schizophrenia and 71.3%, 63.2%, and 47.8% for PD subjects. Only hospitalization during the follow-up period for schizophrenia subjects was significantly associated with good WBCM realization.
Conclusions: We observed rather good results for compliance with clozapine initial monitoring. Other studies are needed to confirm our results.
