Audit of Clozapine prescribing, Hammersmith & Fulham Mental Health Unit (2005)

Summary: NICE prescribing guidelines of Clozapine in the treatment of schizophrenia in patients unresponsive to, or intolerant of, conventional antipsychotic drugs.

Project aims and objectives: Previous audit identified that number of patients treated with clozapine at Hammersmith & Fulham Mental Health Unit are far below than the number expected based on population measures. For all patients currently on Clozapine, we will try to identify the time from diagnosis and duration of treatment prior to the initiation of Clozapine treatment. We wish to measure these against the NICE guidelines. NICE guidelines recommend that patients taking antipsychotics should be asked regularly about adverse effects and this will be assessed by reviewing clozapine clinic notes. Clozapine is a medication that can interact with other psychotropic medication, so we will try to identify concomitant prescribing of psychotropic medication and possible adverse effects and interactions with other concomitantly prescribed medications. For a sub group of patients randomly selected from each CMHT we will identify treatment pathways leading to clozapine.

Methodology: (Population) All patients registered at the Hammersmith and Fulham Mental Health Unit Clozapine Clinic. Additionally all patients who have discontinued clozapine in the last 12 months. Data will be collected from the locally held clozapine clinic notes, and in a sub group from CMHT, inpatient notes and GP records