Dropout Rates And Reasons For Dropout In Patients On Clozapine

BACKGROUND: Clozapine is the treatment of choice for patients with treatment resistant schizophrenia. However, clozapine is associated with high rates of side effects such as hypersalivation, constipation and sedation which often influences medication and treatment adherence. Little information is available from India about the dropout status of patients on clozapine. AIM: To evaluate dropout rates and reason for dropout in patients receiving clozapine METHODOLOGY: Clozapine data bank of the department was used to identify patients on clozapine and their treatment records were reviewed in the month of Jan 2020-March 2020. Patients who did not follow up at least once in last 6 months were considered to have dropped out and were contacted telephonically to understand reasons for dropout. RESULTS: Out of 671 patients on clozapine, 495 (73.8%) were still on regular follow up and remaining 176 (26.2%) had dropped out of treatment. Out of the 176 patients who had dropped out of treatment, 84 could be contacted. Common reasons for dropout were long distance from the hospital (N=27), long waiting time for consultation (N=8), no benefit with treatment (N=17), side effects with medication (N=10), moving away to another place (N=6), refusal by patient (N=7), patient improved so did not feel the need to continue treatment (N=7) and other reasons (N=37). Despite dropping out of treatment from our centre, 51 were still no clozapine from some other centre or were continuing the same on their own. Among those who stopped clozapine, for 19 patients same was stopped by the patient or their caregivers. CONCLUSION: The treatment dropout rates among patients on clozapine is lower compared to the rates reported to other patient groups. The reasons for dropout from treatment are also different than that reported for other treatment groups.