Cargando…

Differences between physicians' and nurse practitioners' viewpoints on reasons for clozapine underprescription

INTRODUCTION: Clozapine (CLZ) is the only proven effective therapy for treatment‐resistant schizophrenia, but it is underutilized across the globe. Previous findings suggest a lack of experience with CLZ prescription and concerns about CLZ's pharmacological characteristics are the prime reasons...

Descripción completa

Detalles Bibliográficos
Autores principales: Okhuijsen‐Pfeifer, Cynthia, Cohen, Dan, Bogers, Jan P. A. M., de Vos, Cato M. H., Huijsman, Elianne A. H., Kahn, René S., Luykx, Jurjen J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625469/
https://www.ncbi.nlm.nih.gov/pubmed/31144470
http://dx.doi.org/10.1002/brb3.1318
_version_ 1783434423471964160
author Okhuijsen‐Pfeifer, Cynthia
Cohen, Dan
Bogers, Jan P. A. M.
de Vos, Cato M. H.
Huijsman, Elianne A. H.
Kahn, René S.
Luykx, Jurjen J.
author_facet Okhuijsen‐Pfeifer, Cynthia
Cohen, Dan
Bogers, Jan P. A. M.
de Vos, Cato M. H.
Huijsman, Elianne A. H.
Kahn, René S.
Luykx, Jurjen J.
author_sort Okhuijsen‐Pfeifer, Cynthia
collection PubMed
description INTRODUCTION: Clozapine (CLZ) is the only proven effective therapy for treatment‐resistant schizophrenia, but it is underutilized across the globe. Previous findings suggest a lack of experience with CLZ prescription and concerns about CLZ's pharmacological characteristics are the prime reasons for CLZ underutilization. To our knowledge, it is currently unknown whether the reasons for underutilization and suggested solutions differ between physicians and nurse practitioners. Such differences are important as nurse practitioners are becoming increasingly involved in prescribing CLZ. METHODS: To examine to what degree physicians and nurse practitioners differ with regard to their take on reasons for CLZ underutilization and suggested solutions, an online questionnaire was distributed to physicians and nurse practitioners. The primary outcome was to compare the patient‐related and prescriber‐related reasons for CLZ underprescription between physicians and nurse practitioners, while secondary outcome measures included the potential solutions to prevent this underprescription. RESULTS: Physicians (N = 112) and nurse practitioners (N = 41) agreed that the two most common reasons for underprescription (patient‐related and prescriber‐related) were refusal to undergo regular blood tests and side‐effect concerns. They also agreed that the third most common prescriber‐related reason was medical complications. Physicians rated patients' unwillingness to switch medication as the third most common reason for CLZ underprescription, whereas nurse practitioners rated refusal to undergo baseline bloodtests as the third most common reason. The solutions to reduce underprescription largely corresponded between both groups. CONCLUSIONS: We conclude that slight differences exist between physicians' and nurse practitioners' viewpoints on patient‐related and prescriber‐related reasons for CLZ underprescription. Future research projects should involve patients to elucidate whether the patient‐related factors put forward by prescribers align with the patients' opinions.
format Online
Article
Text
id pubmed-6625469
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-66254692019-07-17 Differences between physicians' and nurse practitioners' viewpoints on reasons for clozapine underprescription Okhuijsen‐Pfeifer, Cynthia Cohen, Dan Bogers, Jan P. A. M. de Vos, Cato M. H. Huijsman, Elianne A. H. Kahn, René S. Luykx, Jurjen J. Brain Behav Original Research INTRODUCTION: Clozapine (CLZ) is the only proven effective therapy for treatment‐resistant schizophrenia, but it is underutilized across the globe. Previous findings suggest a lack of experience with CLZ prescription and concerns about CLZ's pharmacological characteristics are the prime reasons for CLZ underutilization. To our knowledge, it is currently unknown whether the reasons for underutilization and suggested solutions differ between physicians and nurse practitioners. Such differences are important as nurse practitioners are becoming increasingly involved in prescribing CLZ. METHODS: To examine to what degree physicians and nurse practitioners differ with regard to their take on reasons for CLZ underutilization and suggested solutions, an online questionnaire was distributed to physicians and nurse practitioners. The primary outcome was to compare the patient‐related and prescriber‐related reasons for CLZ underprescription between physicians and nurse practitioners, while secondary outcome measures included the potential solutions to prevent this underprescription. RESULTS: Physicians (N = 112) and nurse practitioners (N = 41) agreed that the two most common reasons for underprescription (patient‐related and prescriber‐related) were refusal to undergo regular blood tests and side‐effect concerns. They also agreed that the third most common prescriber‐related reason was medical complications. Physicians rated patients' unwillingness to switch medication as the third most common reason for CLZ underprescription, whereas nurse practitioners rated refusal to undergo baseline bloodtests as the third most common reason. The solutions to reduce underprescription largely corresponded between both groups. CONCLUSIONS: We conclude that slight differences exist between physicians' and nurse practitioners' viewpoints on patient‐related and prescriber‐related reasons for CLZ underprescription. Future research projects should involve patients to elucidate whether the patient‐related factors put forward by prescribers align with the patients' opinions. John Wiley and Sons Inc. 2019-05-29 /pmc/articles/PMC6625469/ /pubmed/31144470 http://dx.doi.org/10.1002/brb3.1318 Text en © 2019 The Authors. Brain and Behavior published by Wiley Periodicals, Inc. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Okhuijsen‐Pfeifer, Cynthia
Cohen, Dan
Bogers, Jan P. A. M.
de Vos, Cato M. H.
Huijsman, Elianne A. H.
Kahn, René S.
Luykx, Jurjen J.
Differences between physicians' and nurse practitioners' viewpoints on reasons for clozapine underprescription
title Differences between physicians' and nurse practitioners' viewpoints on reasons for clozapine underprescription
title_full Differences between physicians' and nurse practitioners' viewpoints on reasons for clozapine underprescription
title_fullStr Differences between physicians' and nurse practitioners' viewpoints on reasons for clozapine underprescription
title_full_unstemmed Differences between physicians' and nurse practitioners' viewpoints on reasons for clozapine underprescription
title_short Differences between physicians' and nurse practitioners' viewpoints on reasons for clozapine underprescription
title_sort differences between physicians' and nurse practitioners' viewpoints on reasons for clozapine underprescription
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625469/
https://www.ncbi.nlm.nih.gov/pubmed/31144470
http://dx.doi.org/10.1002/brb3.1318
work_keys_str_mv AT okhuijsenpfeifercynthia differencesbetweenphysiciansandnursepractitionersviewpointsonreasonsforclozapineunderprescription
AT cohendan differencesbetweenphysiciansandnursepractitionersviewpointsonreasonsforclozapineunderprescription
AT bogersjanpam differencesbetweenphysiciansandnursepractitionersviewpointsonreasonsforclozapineunderprescription
AT devoscatomh differencesbetweenphysiciansandnursepractitionersviewpointsonreasonsforclozapineunderprescription
AT huijsmanelianneah differencesbetweenphysiciansandnursepractitionersviewpointsonreasonsforclozapineunderprescription
AT kahnrenes differencesbetweenphysiciansandnursepractitionersviewpointsonreasonsforclozapineunderprescription
AT luykxjurjenj differencesbetweenphysiciansandnursepractitionersviewpointsonreasonsforclozapineunderprescription