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Differences between counties in the prescribing of clozapine
Summary
Clozapine prescribing for schizophrenia varies significantly across Norwegian counties. This variation is not linked to the number of patients treated for schizophrenia, suggesting unequal guideline implementation.
Area of Science:
- Psychiatry
- Pharmacology
- Health Services Research
Background:
- National guidelines in Norway recommend clozapine for schizophrenia after treatment failure.
- Clinical pathways aim for equitable mental healthcare nationwide.
- Investigated clozapine prescribing variations across Norwegian counties.
Purpose of the Study:
- To examine the prescribing levels of clozapine in different Norwegian counties.
- To assess geographic disparities in clozapine utilization for schizophrenia treatment.
Main Methods:
- Utilized aggregated data from Norwegian Prescription Database, Norwegian Patient Registry, and Statistics Norway for 2016.
- Analyzed clozapine prescriptions, schizophrenia patient numbers, and population data.
- Correlated clozapine prescribing rates with schizophrenia treatment proportions by county.
Main Results:
- Nationwide clozapine use was 50 per 100,000 inhabitants in 2016.
- Prescribing rates ranged from 38 in Akershus to 76 in Troms county per 100,000.
- No significant correlation found between clozapine prescribing and the proportion of schizophrenia patients in specialist care.
Conclusions:
- Significant geographic variation exists in clozapine prescribing across Norwegian counties.
- Prescribing rates do not correlate with the prevalence of schizophrenia treated in specialist services.
- Uneven implementation of national clozapine guidelines is a likely explanation for observed disparities.
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