PDF(Pubmed)
Abstract：
BACKGROUND: The Mental Welfare Commission for Scotland published a report into the death of a young person, with recommendations for the Royal College of Psychiatry in Scotland Child and Adolescent Faculty; to explore if there were barriers to the use of Clozapine in young people in Scotland.
METHODS: A mixed-methods study was performed using a cross-sectional survey of clinicians working in child and adolescent psychiatry across Scotland, to determine attitudes towards clozapine use and the perceived barriers and facilitators to clozapine treatment.
RESULTS: Results suggest that there may be a lack of clearly defined pathways within and between services, as well as a lack of resources provided for the necessary monitoring of a young person started on clozapine. Multiple respondents felt unskilled in clozapine initiation and had not accessed formal training. The most frequently mentioned themes for improving facilitation of clozapine prescription were that of increased resources and training.
CONCLUSIONS: National policymakers including the Mental Welfare Commission, NHS Education for Scotland, and NHS Scotland should consider these findings to address the potential underutilisation of clozapine for people aged under 18 in services across Scotland. A review of current service provision should take place, with consideration of whether the facilitators to clozapine prescription which our study has highlighted could be implemented more effectively. This may help reduce identified barriers and increase clozapine prescription to those who would benefit from it, potentially improving outcomes for young people with treatment-resistant psychosis.
METHODS: A mixed-methods study was performed using a cross-sectional survey of clinicians working in child and adolescent psychiatry across Scotland, to determine attitudes towards clozapine use and the perceived barriers and facilitators to clozapine treatment.
RESULTS: Results suggest that there may be a lack of clearly defined pathways within and between services, as well as a lack of resources provided for the necessary monitoring of a young person started on clozapine. Multiple respondents felt unskilled in clozapine initiation and had not accessed formal training. The most frequently mentioned themes for improving facilitation of clozapine prescription were that of increased resources and training.
CONCLUSIONS: National policymakers including the Mental Welfare Commission, NHS Education for Scotland, and NHS Scotland should consider these findings to address the potential underutilisation of clozapine for people aged under 18 in services across Scotland. A review of current service provision should take place, with consideration of whether the facilitators to clozapine prescription which our study has highlighted could be implemented more effectively. This may help reduce identified barriers and increase clozapine prescription to those who would benefit from it, potentially improving outcomes for young people with treatment-resistant psychosis.
摘要：
背景：苏格兰精神福利委员会发布了一份关于年轻人死亡的报告，为苏格兰儿童和青少年学院的皇家精神病学学院提供建议；探索在苏格兰年轻人中使用氯氮平是否存在障碍。
方法：一项混合方法研究是通过对苏格兰儿童和青少年精神病学临床医生的横断面调查进行的，确定对使用氯氮平的态度以及对氯氮平治疗的感知障碍和促进因素。
结果：结果表明，服务内部和服务之间可能缺乏明确定义的路径，以及缺乏对年轻人进行必要监测的资源开始服用氯氮平。多名受访者认为氯氮平入门技术不熟练，也没有接受过正式培训。改善氯氮平处方便利化的最常见主题是增加资源和培训。
结论：包括精神福利委员会在内的国家决策者，NHS苏格兰教育，苏格兰NHS应考虑这些发现，以解决苏格兰18岁以下人群中潜在的氯氮平未充分利用的问题。应该对目前的服务提供进行审查，考虑是否可以更有效地实施我们研究强调的氯氮平处方的促进剂。这可能有助于减少已发现的障碍，并增加氯氮平处方给那些从中受益的人，可能改善患有难治性精神病的年轻人的预后。
方法：一项混合方法研究是通过对苏格兰儿童和青少年精神病学临床医生的横断面调查进行的，确定对使用氯氮平的态度以及对氯氮平治疗的感知障碍和促进因素。
结果：结果表明，服务内部和服务之间可能缺乏明确定义的路径，以及缺乏对年轻人进行必要监测的资源开始服用氯氮平。多名受访者认为氯氮平入门技术不熟练，也没有接受过正式培训。改善氯氮平处方便利化的最常见主题是增加资源和培训。
结论：包括精神福利委员会在内的国家决策者，NHS苏格兰教育，苏格兰NHS应考虑这些发现，以解决苏格兰18岁以下人群中潜在的氯氮平未充分利用的问题。应该对目前的服务提供进行审查，考虑是否可以更有效地实施我们研究强调的氯氮平处方的促进剂。这可能有助于减少已发现的障碍，并增加氯氮平处方给那些从中受益的人，可能改善患有难治性精神病的年轻人的预后。
