Research

Comparison of sole nurse and team-delivered community clozapine services for people with treatment-resistant schizophrenia


Reference:

Gage, H., Family, H., Murphy, F., Williams, P., Sutton, J. and Taylor, D., 2015. Comparison of sole nurse and team-delivered community clozapine services for people with treatment-resistant schizophrenia. Journal of Advanced Nursing, 71 (3), pp. 547-558.

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    Official URL:

    http://dx.doi.org/10.1111/jan.12527

    Abstract

    Aim. To compare sole nurse and doctor-led multidisciplinary team delivery of community clozapine services for people with treatment-resistant schizophrenia. Background. Around 20% of people with schizophrenia are treatment resistant and fail to respond to front line medications. Clozapine, a second-line treatment, has potentially serious side effects requiring regular monitoring. Different models of community clozapine services are emerging in the British National Health Service, but there is little evidence about which is best. Design. Questionnaire survey of service users. Methods. All patients on the lists of seven clozapine clinics (four sole nurse, three multidisciplinary team) in one trust were invited to participate, 2009–2010. Forward stepwise regression was used to investigate associations between patient well-being, functioning, self-efficacy and satisfaction, and clinic model attended, controlling for socio-demographic and health characteristics and processes of care. Use (and costs) of other health and social services accessed was compared between models. Results. Sixty-six service users (35% participation rate) responded. Well-being and functioning were associated with patient characteristics and processes of care, not clinic model. Patients managed by sole nurses reported, over 3 months: more community psychiatric nurse visits and hospital psychiatrist appointments. Clinic list size affects costs per patient. Conclusions. Multidisciplinary team delivery may reduce use of other services. Although multidisciplinary team delivery is regarded as best practice, sole nurses can effectively provide clozapine services and may be warranted in areas of low population density.

    Details

    Item Type Articles
    CreatorsGage, H., Family, H., Murphy, F., Williams, P., Sutton, J. and Taylor, D.
    DOI10.1111/jan.12527
    Uncontrolled Keywordsclozapine, community care, costs, multidisciplinary team, nurse-led,
    DepartmentsFaculty of Science > Pharmacy & Pharmacology
    Publisher StatementGage_et_al_Revised_2_Comparing_sole_nurse_and_team_delivered_community_clozapine_ALL.docx: This is the peer reviewed version of the following article: Gage, H., Family, H., Murphy, F., Williams, P., Sutton, J., & Taylor, D. (2015). Comparison of sole nurse and team-delivered community clozapine services for people with treatment-resistant schizophrenia. Journal of Advanced Nursing, 71(3), 547-558. , which has been published in final form at http://dx.doi.org/10.1111/jan.12527. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving."
    RefereedYes
    StatusPublished
    ID Code41869

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