28 / 34
Volume 9
Journal of Neurology and Neuroscience
ISSN: 2171-6625
Page 70
JOINT EVENT
July 23-24, 2018 Birmingham, UK
&
24
th
International Conference on
Neuroscience and Neurochemistry
26
th
Edition of International Conference on
Clinical Psychology and Neuroscience
At what point does a community model benefit or fail persons prescribed clozapine?
Mary Claire Hanlon, Peter Mac Isaac, Anthony Paul O’Brien, Dominiek Coates
and
Marcia Fogarty
The University of Newcastle, Australia
Statement of the Problem:
In Australia, the prescription, delivery and monitoring of clozapine - for people with treatment-
resistant 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 publicly-
funded 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 clozapine-
related 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.
Mary-claire.hanlon@newcastle.edu.auJ Neurol Neurosci 2018, Volume 9
DOI: 10.21767/2171-6625-C2-012