Computerized relational database for monitoring clozapine therapy

The use of a computerized relational database to satisfy the patient-monitoring requirements of clozapine's manufacturer at an Oregon state psychiatric facility is described. The pharmacy department designed a computerized system to efficiently manage the patient-monitoring requirements of clozapine's manufacturer. A relational database program allows information in database files to be readily retrieved and organized into standardized or customized reports. These reports provide white blood cell (WBC) counts to the drug's manufacturer, patient discharge information to other clozapine providers, psychiatric test results to treating physicians, financial data to hospital administration, and other key data related to the facility's clozapine treatment system. The computerized system minimized the additional workload required to dispense clozapine, decreased the cost of clozapine by $234,441 compared with the cost under the closed distribution system, and provided for comprehensive clinical monitoring. Between May 1991 and October 1992, 168 clozapine recipients were monitored; pharmacists notified physicians about 86 patients not meeting WBC-count criteria. The use of a computerized relational database enabled a state psychiatric hospital to efficiently manage the burden of monitoring clozapine recipients.