Mary Claire Hanlon, Peter Mac Isaac, Anthony Paul O��?Brien, Dominiek Coates and Marcia Fogarty
The University of Newcastle, Australia
Posters & Accepted Abstracts: J Neurol Neurosci
Statement of the Problem: In Australia, the prescription, delivery and monitoring of clozapine - for people with treatmentresistant schizophrenia - has moved from the hospital setting, to various community models. While this might reduce stigma associated with having an intractable psychotic disorder, clozapine use must be strictly monitored. Simultaneously, a new system of healthcare has emerged (called the National Disability Insurance Scheme, NDIS), rolled out in the Hunter Region of New South Wales, in which the Federal Government pays registered community-managed organizations (CMOs) to provide supportive care to people with severe mental illnesses. It is currently unknown how these community models impact the wellbeing of participants. We aim to ascertain the capacity for CMO staff to identify and manage clozapine-related adverse events; while documenting the clozapine care pathway across the community. Methodology & Theoretical Orientation: The study utilizes a mixed-method approach with clozapine recipients, their careers, and relevant clinical and CMO staff, including semi-structured qualitative interviews and a quality of life survey for recipients. Findings: At the time of writing, results were preliminary, showing two clear pathways. The first - incorporating the publiclyfunded mental health service and associated community mental health team, general practitioners and pharmacists - showed appropriate knowledge of the guidelines, risks and actions required to protect participants from adverse treatment events. The second pathway - incorporating CMO staff - showed variable competence and confidence in proactively engaging with participants to reduce risks of clozapine-related incidents. CMO staff could benefit from training in clozapine use, monitoring and management, as well as up skilling in motivational interviewing, to engage participants to actively prevent clozapinerelated side effects, hospitalizations and deaths. Additionally, continued community involvement necessitates a comprehensive data management approach combining all prescribing, physical and mental health monitoring data, as well as evaluation of support worker knowledge and attitudes.
E-mail:
Mary-claire.hanlon@newcastle.edu.au
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