Faculty Opinions recommendation of Adherence to treatment guidelines in clinical practice: study of antipsychotic treatment prior to clozapine initiation.

2013 ◽  
Author(s):  
Driss Moussaoui ◽  
Adil Khoubila
Keyword(s):  
Clinical Practice ◽  
Treatment Guidelines ◽  
Antipsychotic Treatment ◽  
Adherence To Treatment ◽  
Practice Study

scholarly journals Adherence to treatment guidelines in clinical practice: study of antipsychotic treatment prior to clozapine initiation

2012 ◽  
Vol 201 (6) ◽  
pp. 481-485 ◽  
Author(s):  
Oliver D. Howes ◽  
Francis Vergunst ◽  
Siobhan Gee ◽  
Philip McGuire ◽  
Shitij Kapur ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Demographic Data ◽  
Antipsychotic Treatment ◽  
High Dose ◽  
Adherence To Treatment ◽  
Treatment Resistant ◽  
National Guidelines ◽  
Prior Use ◽  
The Mean ◽  
High Doses

BackgroundClozapine is the only antipsychotic drug licensed for treatment-resistant schizophrenia but its use is often delayed. Since previous studies, national guidelines on the use of clozapine and other antipsychotics have been disseminated to clinicians.AimsTo determine the theoretical delay to clozapine initiation and to quantify the prior use of antipsychotic polypharmacy and high-dose antipsychotic treatment.MethodClinico-demographic data were extracted from the treatment records of all patients commencing clozapine in our centre between 2006 and 2010.ResultsComplete records were available for 149 patients. The mean theoretical delay in initiating clozapine was 47.7 months (s.d. = 49.7). Before commencing clozapine, antipsychotic polypharmacy and high-dose treatment was evident in 36.2 and 34.2% of patients respectively. Theoretical delay was related to illness duration (β = 0.7, P<0.001) but did not differ by gender or ethnicity.ConclusionsSubstantial delays to clozapine initiation remain and antipsychotic polypharmacy and high doses are commonly used prior to clozapine, despite treatment guidelines.

Treatment of hypertension and adherence to treatment guidelines in clinical practice: An Italian study

2005 ◽  
Vol 22 (2) ◽  
pp. 96-106 ◽  
Author(s):  
Ettore Malacco ◽  
Claudio Ferri ◽  
Anna Maria Grandi ◽  
Michael Ochan Kilama ◽  
Andrea Giovanni Soglian ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Treatment Guidelines ◽  
Adherence To Treatment ◽  
Italian Study ◽  
Treatment Of Hypertension

Mycoplasma genitalium: test positivity in syndromic presentations and clinicians’ adherence with treatment guidelines at Sydney Sexual Health Centre

2021 ◽  
pp. 095646242110225
Author(s):  
Calvin Cheung ◽  
Christopher Bourne ◽  
Rick Varma
Keyword(s):  
Decision Making ◽  
Antimicrobial Resistance ◽  
Sexual Health ◽  
Treatment Guidelines ◽  
Health Centre ◽  
Diagnostic Testing ◽  
Mycoplasma Genitalium ◽  
Macrolide Resistance ◽  
Adherence To Treatment ◽  
Real World Data

Mycoplasma genitalium ( M.genitalium) is associated with urethritis, cervicitis, pelvic inflammatory disease, proctitis and epididymitis. Its treatment is complicated by antimicrobial resistance. To assess clinicians’ adherence to M.genitalium diagnostic testing recommendations for syndromic presentations, as well as resistance-guided management of M.genitalium at Sydney Sexual Health Centre, we reviewed patients presenting between August and December 2018. 349/372 (94%) syndromic presentations were tested for M.genitalium with 16% M.genitalium test positivity and 81% macrolide resistance. 16/27 (59%) macrolide-sensitive infections and 65/77 (84%) macrolide-resistant infections received resistance-guided treatment. Tests of cure (TOCs) were unnecessarily ordered for 82% macrolide-sensitive cases, while 88% macrolide-resistant cases were correctly ordered TOCs. Co-existing STIs at the time of macrolide-sensitive ( p = 0.30) or macrolide-resistant M.genitalium ( p = 0.94) diagnosis did not significantly affect adherence to treatment guidelines. This study confirms the expected prevalence of M.genitalium and macrolide resistance in syndromic presentations while our real-world data highlight the decision-making challenges involved with managing M.genitalium, offering insights for further research.

‘Adults with Parkinson's disease and hallucinations or delusions can have treatment with clozapine if they need to’

2021 ◽  
pp. 1-3
Author(s):  
Eileen Joyce
Keyword(s):  
Mental Health ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Practice ◽  
National Health Service ◽  
Quality Standards ◽  
Antipsychotic Treatment ◽  
Current Clinical Practice ◽  
Clozapine Treatment ◽  
Care Systems

SUMMARY Clozapine is the only antipsychotic licensed for treatment of Parkinson's disease psychosis (PDP) but is infrequently used in the National Health Service because of obstacles to the integration of hospital-based neurological/geriatric services with clozapine clinics run by community mental health teams. This commentary points out the mismatch between NICE quality standards on antipsychotic treatment for PDP and current clinical practice. It suggests that forthcoming integrated care systems should be able to overcome these obstacles, enabling innovative models for providing clozapine treatment for PDP such as those described by Taylor et al, so that clozapine treatment becomes a right for patients and their families.

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