Table 3 Clinician-perceived reasons for current non-clozapine prescribing for included clozapine-eligible patients.

From: Non-prescribing of clozapine for outpatients with schizophrenia in real-world settings: The clinicians’ perspectives

Reasons for non-clozapine treatment as listed in the survey questionnaires

1. Distribution of all chosen reasons (n (%))

2. Distribution of chosen main reasons (n (%))

 

In total (ncases=39)

By care providers (ncases=37)

By psychiatrists (ncases=33)

In total (ncases=38)

By care providers (ncases=36)

By psychiatrists (ncases=27)

1. Expected non-compliance with blood sampling

24 (61.5)*

19 (51.4)*

16 (48.5)*

6 (15.8)

6 (16.7)*

0 (0)

Expected patient refusal (any reason)

(24 (61.5))

(20 (54.1))

(11 (33.3))

(10 (26.3))

(8 (22.2))

(2 (7.4))

2. Due to blood sampling

18 (46.2),

16 (43.2),

8 (24.2),

5 (13.2),

5 (13.9),

0 (0),

3. Due to the side-effect profile

7 (18.0),

6 (16.2),

2 (6.1),

2 (5.3),

1 (2.8),

1 (3.7),

4. Due to other reasons

10 (25.6)

7 (18.9)

4 (12.1)

3 (7.9)

2 (5.6)

1 (3.7)

(Issues related to blood sampling in total) (i.e., expected non-compliance with OR refusal due to sampling)

(27 (69.2)*)

(24 (64.9)*)

(17 (51.5)*)

(11 (29.0))

(11 (30.6)*)

(0 (0))

5. Expected non-compliance with clozapine

19 (48.7)

14 (37.8)

14 (42.4)

9 (23.7)

6 (16.7)*

6 (22.2)

6. Other reasons

13 (33.3)

6 (16.2)

8 (24.2)

4 (10.5)

2 (5.6)

3 (11.1)

Added “other” reasons:

- Cognitive impairment

8 (20.5),

4 (10.8),

5 (15.2),

1 (2.6),

0 (0),

1 (3.7),

- Substance abuse

6 (15.4),

2 (5.4),

5 (15.2),

1 (2.6),

0 (0),

1 (3.7),

- Old age

1 (2.6),

1 (2.7),

1 (3.0),

1 (2.6),

1 (2.8),

1 (3.7),

- Only temporary responsibility of treatment

1 (2.6),

0 (0),

1 (3.0),

1 (2.6),

0 (0),

1 (3.7),

- Clozapine is the treatment of last resort

1 (2.6)

1 (2.7)

0 (0)

1 (2.6)

1 (2.8)

0 (0)

7. Current treatment status

14 (35.9)

5 (13.5)

10 (30.3)

12 (31.6)*

3 (8.3)

11 (40.7)*

8. Don’t know

8 (20.5)

6 (16.2)

4 (12.1)

7 (18.4)

6 (16.7)*

3 (11.1)

Added reasons for not knowing:

- Don’t know the patient that well

4 (10.3),

2 (5.4),

3 (9.1),

3 (7.9),

2 (5.6),

2 (7.4),

- Not responsible for drug treatment

4 (10.3)

4 (10.8)

0 (0)

4 (10.5)

4 (11.1)

0 (0)

9. Concerns about side effects

5 (12.8)

4 (10.8)

3 (9.1)

1 (2.6)

1 (2.8)

0 (0)

Added side effects:

- Weight gain

2 (5.1),

2 (5.4),

1 (3.0),

1 (2.6),

1 (2.8),

0 (0),

- Sedation

2 (5.1),

2 (5.4),

0 (0),

0 (0),

0 (0),

0 (0),

- Patient concerned about side effects (unspecified)

2 (5.1)

1 (2.7)

2 (6.1)

1 (2.6)

1 (2.8)

0 (0)

10. Concerns about somatic issues

4 (10.3)

4 (10.8)

2 (6.1)

2 (5.3)

2 (5.6)

1 (3.7)

Added somatic concerns:

- Current overweight

2 (5.1),

2 (5.4),

1 (3.0),

0 (0.0),

0 (0.0),

0 (0.0),

- Chronic obstructive pulmonary disease (COPD)

2 (5.1),

2 (5.4),

1 (3.0),

1 (2.6),

1 (2.8),

0 (0),

- Previous lymphoma

1 (2.6)

1 (2.7)

1 (3.0)

1 (2.6)

1 (2.8)

1 (3.7)

11. Due to a previous refusal of clozapine

3 (7.7)

2 (5.4)

3 (9.1)

1 (2.6)

1 (2.8)

1 (3.7)

12. Due to organizational issues

3 (7.7)

2 (5.4)

1 (3.0)

1 (2.6)

1 (2.8)

1 (0)

13. Due to treatment with contraindicated drugs

0 (0)

0 (0)

0 (0)

0 (0)

0 (0)

0 (0)

  1. Notes
  2. The table shows the distribution of case-specific reasons for non-clozapine treatment, chosen by clinicians. The clinicians were asked to choose all reasons of relevance to a specific patient-case (column 1), as well as the main reason (the reason considered the most important one in each patient-case) (column 2).
  3. The distribution is shown as the number and percent (n (%)) of patient cases for which a particular reason is chosen; in total, by care providers and by psychiatrists.
  4. *The most frequent choices are marked with an asterisk*.
  5. In some patient-cases, both a psychiatrist and a clinical care provider returned a questionnaire regarding the same patient, however, in other cases only one clinician returned a questionnaire or one had skipped parts of the survey. The number of patient-cases with clinician responses thus differs between the total number of cases, the number of cases stratified by care providers and psychiatrists, and between choices and main choices.
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