An education tool on clozapin: From needs assessment to patient satisfaction

Abstract

Clozapine remains the gold-standard for resistant schizophrenia. However, it is associated with serious adverse events and a low patient adherence that could be enhanced by therapeutic education. Identifying patients' needs is a prerequisite for building educational tools. The aims of the study were to build an adapted information tool after evaluating patients' knowledge and expectations regarding their clozapine treatment, and to estimate patients' satisfaction with this tool. Patients' knowledge and expectations were evaluated by means of a short oral and semi-structured interview, based on an 11-item questionnaire developed by pharmacists and psychiatrists. Patients with schizophrenia or a schizo-affective disorder were included from four different care structures of the university psychiatry department. Finally, an education tool was built based on patients' answers and tested among them. Between February 2020 and September 2021, 51 patients (17 women) around 36 years of age were interviewed. 45% were aware of a clozapine indication. Half of the patients did not know how to react in case of forgetting a dose. Although the rhythm of blood tests was understood by most patients (84%), only 29% estimated they had a general knowledge about them. Many patients (73%) could cite no more than two adverse effects. Regarding interactions, 69% had a partial knowledge and 31% none at all. Patients preferred to receive information in the form of a brochure. The subsequent brochure was tested on 15 patients who were satisfied with it. The survey revealed a general lack of knowledge among patients about their clozapine treatment. The tool built based on patients' answers has been adapted and liked by patients.

Keywords: Adherence; Clozapin; Clozapine; Observance; Outil d’éducation thérapeutique; Schizophrenia; Schizophrénie; Therapeutic education tool.