Echocardiography and clozapine: Is current clinical practice inhibiting use of a potentially life-transforming therapy?

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Author(s)
Robinson, Gail
Kisely, Steve
Siskind, Dan
Flanagan, Robert J
Wheeler, Amanda J
Griffith University Author(s)
Year published
2017
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Approximately 33% of patients with schizophrenia are treatment-refractory, yet clozapine remains underused, even though it is the most effective treatment.1,2 One barrier is routine echocardiography, which in Australia is performed before clozapine initiation, six months afterwards and then annually.3 Elsewhere, such as in New Zealand, routine echocardiography is generally restricted to the initiation of therapy, while in the UK, it is not routine practice at all. Importantly, the latest guidelines from The Royal Australian and New Zealand College of Psychiatrists (RANZCP) suggest routine annual echocardiography adds little ...
View more >Approximately 33% of patients with schizophrenia are treatment-refractory, yet clozapine remains underused, even though it is the most effective treatment.1,2 One barrier is routine echocardiography, which in Australia is performed before clozapine initiation, six months afterwards and then annually.3 Elsewhere, such as in New Zealand, routine echocardiography is generally restricted to the initiation of therapy, while in the UK, it is not routine practice at all. Importantly, the latest guidelines from The Royal Australian and New Zealand College of Psychiatrists (RANZCP) suggest routine annual echocardiography adds little to the detection of cardiomyopathy.4 We therefore review the evidence for routine echocardiography. This is particularly relevant to general practitioners (GPs) as they become more involved in managing patients on clozapine through shared-care arrangements.
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View more >Approximately 33% of patients with schizophrenia are treatment-refractory, yet clozapine remains underused, even though it is the most effective treatment.1,2 One barrier is routine echocardiography, which in Australia is performed before clozapine initiation, six months afterwards and then annually.3 Elsewhere, such as in New Zealand, routine echocardiography is generally restricted to the initiation of therapy, while in the UK, it is not routine practice at all. Importantly, the latest guidelines from The Royal Australian and New Zealand College of Psychiatrists (RANZCP) suggest routine annual echocardiography adds little to the detection of cardiomyopathy.4 We therefore review the evidence for routine echocardiography. This is particularly relevant to general practitioners (GPs) as they become more involved in managing patients on clozapine through shared-care arrangements.
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Journal Title
Australian Family Physician
Volume
46
Issue
3
Copyright Statement
© 2017 Australian Family Physician. Reproduced with permission. Permission to reproduce must be sought from the publisher, The Royal Australian College of General Practitioners.
Subject
Clinical sciences
Health care administration