Abstract
Aims and MethodWe aimed to examine variations in clozapine prescribing in all 12 NHS trusts with catchment area mental health services in one English county, over a 2-year period. We tested a series of hypotheses to explain the variation in prescribing of clozapine.ResultsA 34-fold variation between trusts in rates of clozapine provision was found after adjusting for measures of local population need. This variation did not change over the 2 years examined. It was not explained by differences in resource level.Clinical ImplicationsThe evidence base is strong for the effectiveness and likely cost-effectiveness of clozapine in severe schizophrenia. Our data indicate that variations in evidence-based clinical practice at the provider level led to the wide variation in clozapine prescribing.
Highlights
We aimed to examine variations in clozapine prescribing in all 12 NHS trusts with catchment area mental health services in one English county, over a 2-year period
The evidence base is strong for the effectiveness and likely costeffectiveness of clozapine in severe schizophrenia
Clozapine has been shown to be better in treating symptoms of schizophrenia than conventional antipsychotic drugs
Summary
We aimed to examine variations in clozapine prescribing in all 12 NHS trusts with catchment area mental health services in one English county, over a 2-year period. A 34-fold variation between trusts in rates of clozapine provision was found after adjusting for measures of local population need. Our data indicate that variations in evidence-based clinical practice at the provider level led to the wide variation in clozapine prescribing.
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