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Clozapine clinics in north Wales - service evaluation audit

Published online by Cambridge University Press:  18 June 2021

Jawad Raja ,
Zeenish Azhar  and
Masood Malik
Jawad Raja*
Affiliation:
ST5 Betsi Cadwaladr University Health Board
Zeenish Azhar
Affiliation:
CT2 Betsi Cadwaladr University Health Board
Masood Malik
Affiliation:
Clinical Director Betsi Cadwaladr University Health Board
*
*corresponding author.
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Abstract

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Aims

  1. 1. Quality of clozapine clinic appointment

  2. 2. Effectiveness of clozapine clinic servive

  3. 3. Compliance with BCUHB guidelines for physical health monitoring in clozapine clinics

  4. 4. We retrospectively audited 40 case notes 10 each from 4 differtent CMHT clozapine clinics

My role in the Project & How does this represent my practice?

  1. 1. I was the audit and overall lead for this project

  2. 2. I formulated the audit tool and registered my project with Audit Registration Team

  3. 3. I lead data collection and compilation of results

Background

  1. 1. This audit followed up from a Coroner's investigation for a clozapine clinic patient

  2. 2. Clozapine is used for Treatment Resistant Schizophrenia but needs close monitoring due to potentially fatal side effects

  3. 3. NICE recommends annual monitoring of weight, blood pressure, waist measurement, blood glucose and plasma lipid levels

Method

  1. 1. Has the patient been seen in the past year by clinician to monitor response to clozapine treatment?

  2. 2. Has the clozapine plasma level been measured during the last year of treatment?

  3. 3. Is brief MSE & Risk assessment documented during review?

  4. 4. Has Life style modification advice been provided?

  5. 5. Has annual physical health been completed?

  6. 6. Has Annual CTP/CPA been completed and documented?

  7. 7. Has the patient been allocated a named care coordinator?

  8. 8. Has clozapine side effects monitoring been documented?

Conclusion

  1. 1. Clozapine is a superior medication for the treatment of refractory schizophrenia and is also be effective for other conditions

  2. 2. Clozapine is underused due to a variety of barriers related to the drug and its properties, the health care system & regulatory requirements

  3. 3. This service evaluation/quality improvement project provides the framework for clozapine clinics evaluation and recommends strategies for improvement

Type
Service Evaluation
Information
BJPsych Open , Volume 7 , Supplement S1: Abstracts of the RCPsych Virtual International Congress 2021, 21–24 June , June 2021 , pp. S343
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists
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