title: Clozapine prescription and quality of life in Chinese patients with schizophrenia treated in primary care.
abstract: OBJECTIVE
  Clozapine is frequently used to treat schizophrenia in China. Maintenance treatment for clinically stable patients with schizophrenia is usually provided by Chinese primary care physicians, but no study has investigated the frequency of its use prescribed by primary care physicians. This study described the frequency, demographic and clinical characteristics of clozapine treatment and its impact on insight and quality of life (QOL) of patients with schizophrenia treated in primary care in China.
  
  
  METHODS
  A total of 623 patients with schizophrenia treated in 22 primary care services in Guangzhou, China in 2013 formed the study sample. Patients' socio-demographic and clinical characteristics including psychopathology, medication side effects and QOL were recorded using a standardized protocol and data collection.
  
  
  RESULTS
  The frequency of clozapine prescription was 35.6% with a mean daily dose of 127.7±88.2 mg. There were no significant differences between the patients with and without clozapine in either of the QOL domains after controlling the confounding factors. Multiple logistic regression analyses revealed that patients on clozapine had younger age of onset, more hospitalizations, more severe extrapyramidal side effects, but better insight and fewer prescriptions of first generation antipsychotics.
  
  
  CONCLUSIONS
  Clozapine use was found to be common and associated with better insight in patients with schizophrenia treated in primary care in China. Further examination of the rationale and appropriateness of clozapine in primary care in China is warranted.
authors.affiliation: Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China.
authors.forename: C-L
authors.initials: CL
authors.lastname: Hou
authors.affiliation: Guangzhou Yuexiu Center for Disease Control and Prevention, Guangdong Province, China.
authors.forename: M-Y
authors.initials: MY
authors.lastname: Cai
authors.affiliation: Ningxia Mental Health Center, Ningxia Ning-An Hospital, Ningxia Province, China.
authors.forename: X-R
authors.initials: XR
authors.lastname: Ma
authors.affiliation: Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zang
authors.affiliation: Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China.
authors.forename: F-J
authors.initials: FJ
authors.lastname: Jia
authors.affiliation: Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China.
authors.forename: Y-Q
authors.initials: YQ
authors.lastname: Lin
authors.affiliation: Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: H F K
authors.initials: HF
authors.lastname: Chiu
authors.affiliation: The University of Notre Dame Australia/Marian Centre, Perth, Australia.
authors.forename: G S
authors.initials: GS
authors.lastname: Ungvari
authors.affiliation: Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: C H
authors.initials: CH
authors.lastname: Ng
authors.affiliation: Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: B-L
authors.initials: BL
authors.lastname: Zhong
authors.affiliation: Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China.
authors.forename: X-L
authors.initials: XL
authors.lastname: Cao
authors.affiliation: Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.affiliation: International Center for Medical Research, School of Medicine, Kobe University, Kobe, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Shinfuku
authors.affiliation: Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
authors.forename: Y-T
authors.initials: YT
authors.lastname: Xiang
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use; D044466:Asian People / Q000523:psychology*; D003024:Clozapine / Q000009:adverse effects / Q000627:therapeutic use*; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011788:Quality of Life; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology
chemical_list: D014150:Antipsychotic Agents; D003024:Clozapine