Clozapine eligibility: the effect of stringent criteria on ethnic, gender and age subgroups of schizophrenic patients.
1. The purpose of this retrospective chart review study was to determine whether broad and stringent criteria differentially impact clozapine eligibility in ethnic, gender, and age subgroups of schizophrenic patients. 2. 505 patients charts were selected from a random cluster sample of mental health patients known to the city and county of San Francisco. Information related to clozapine eligibility was abstracted by trained non-clinical personnel. The impact of subgroup membership on eligibility was examined using logistic regression procedures. 3. Even under the broadest interpretation of FDA requirements for clozapine use, Asian patients were less likely to be eligible, since fewer Asian patients met clozapine treatment requirements. Under more stringent eligibility criteria, older patients were more likely to be excluded from eligibility when TD does not automatically satisfy treatment criteria, and younger patients were more likely to lose eligibility if the number of required adequate medication trials increases to three. 4. Broad eligibility criteria tend to differentially exclude Asian patients while more stringent criteria differentially exclude younger and older patients.
Juarez-Reyes
M G
MG
Department of Psychiatry, University of California San Francisco, USA.
Shumway
M
M
Battle
C
C
Bacchetti
P
P
Hansen
M S
MS
Hargreaves
W A
WA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003024:Clozapine / Q000009:adverse effects / Q000627:therapeutic use*; D004608:Eligibility Determination; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012044:Regression Analysis; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D012737:Sex Factors; D014481:United States; D014486:United States Food and Drug Administration
D014150:Antipsychotic Agents; D003024:Clozapine