Racial Disparities in Clozapine Prescription Patterns Among Patients With Schizophrenia

Area of Science:

• Psychiatry and Mental Health
• Health Services Research
• Health Equity

Background:

• Clozapine is a critical treatment for treatment-resistant schizophrenia.
• Previous studies suggest demographic factors influence clozapine prescription rates.
• Understanding these disparities is vital for equitable patient care.

Purpose of the Study:

• To investigate the impact of race, social determinants of health (SVI), gender, rurality, and care patterns on clozapine prescription rates in schizophrenia patients.
• To identify factors associated with receiving clozapine versus other antipsychotic medications.

Main Methods:

• Cross-sectional observational study of 3,160 adult schizophrenia patients (Oct 2015 - Nov 2021).
• Utilized electronic health records and the Social Vulnerability Index (SVI).
• Employed logistic regression and sensitivity analysis to compare patient groups.

Main Results:

• White race, higher community minority status/language SVI scores, and longer treatment duration were linked to increased clozapine likelihood.
• Black patients showed a lower likelihood of receiving clozapine compared to White patients.
• Gender, rurality, age at first diagnosis, and ethnicity did not significantly impact clozapine prescription rates.

Conclusions:

• Significant racial disparities exist in clozapine prescription for schizophrenia patients.
• Social determinants of health and treatment duration influence clozapine access.
• Further research is needed to address and mitigate these treatment disparities for improved outcomes.