A qualitative study of clinicians' perspectives on reasons for delays in clozapine initiation.

Abstract

To elicit mental health clinicians' views on the reasons for delayed initiation of clozapine treatment. Thematic analysis of transcripts from a semi-structured interview of 15 mental health clinicians. Four major themes emerged from data analysis: Patient and Carer Factors, Medication factors, Protocol factors, and Prescriber factors. Patient and carer anxiety over side effects and experience of stigma, difficulties in implementing the monitoring protocol, problems with community managing of treatment, prescriber preferences and practices, and gaps in mental health services were some of the reasons identified. Education and support to patients and carers, a modified monitoring protocol, establishing clozapine clinics, improved early intervention services, and upskilling of clinicians can promote early clozapine initiation.