What is the current scope of research assessing patients’ and clinicians’ perspectives on clozapine treatment? A comprehensive scoping review

Objectives Clozapine is continuously underused. The existing systematic reviews addressing barriers to clozapine prescribing primarily focus on clinical staff’s attitudes and perceived barriers to prescribing. However, a preliminary literature search revealed additional literature on the subject not...

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Main Authors: Jimmi Nielsen, Erik Simonsen, Ole Jakob Storebø, Michelle Iris Jakobsen, Stephen F Austin, Julie Perrine Schaug
Format: Article
Language:English
Published: BMJ Publishing Group 2025-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/1/e085956.full
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author Jimmi Nielsen
Erik Simonsen
Ole Jakob Storebø
Michelle Iris Jakobsen
Stephen F Austin
Julie Perrine Schaug
author_facet Jimmi Nielsen
Erik Simonsen
Ole Jakob Storebø
Michelle Iris Jakobsen
Stephen F Austin
Julie Perrine Schaug
author_sort Jimmi Nielsen
collection DOAJ
description Objectives Clozapine is continuously underused. The existing systematic reviews addressing barriers to clozapine prescribing primarily focus on clinical staff’s attitudes and perceived barriers to prescribing. However, a preliminary literature search revealed additional literature on the subject not previously included in systematic reviews, including literature on patient perspectives. A scoping review is warranted to map the scope of primary studies on patients’ and/or clinicians’ perspectives on clozapine treatment and to identify gaps in research.Design A scoping review was designed and reported in accordance with established guidelines for scoping reviews.Data sources The electronic databases Cochrane Library, CINAHL, Web of Science, PsycINFO, MEDLINE, EMBASE, Google Scholar and two grey literature databases were searched. Furthermore, citation tracking of selected studies was undertaken.Eligibility criteria We included primary, empirical studies reporting clinicians’ and/or patients’ perspectives on clozapine treatment. No limitation was set for the year of publication or type of primary study.Data extraction and synthesis Two researchers independently screened for studies, extracted the data and coded the content. Findings were summarised visually and narratively.Results 146 studies were included. Most studies reported on patients’ or clinicians’ perspectives on active clozapine treatment or on clinicians’ perspectives on barriers to clozapine initiation in general. Three gaps in research were identified: (1) clozapine-eligible, yet clozapine-naïve, patients’ attitudes towards clozapine commencement, (2) clinicians’ reasons for clozapine withholding and perceived facilitators of clozapine treatment in specific patient-cases and (3) patient and clinician perspectives on clozapine discontinuation, continuation and rechallenge in specific patient cases.Conclusions Research on clozapine perspectives tends to repeat itself. Future studies addressing the identified gaps in evidence could provide the insights needed to optimise clozapine utilisation.
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spelling doaj-art-47972eaa1c5045c3903a2ff5bd56ce082025-08-20T02:02:20ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2024-085956What is the current scope of research assessing patients’ and clinicians’ perspectives on clozapine treatment? A comprehensive scoping reviewJimmi Nielsen0Erik Simonsen1Ole Jakob Storebø2Michelle Iris Jakobsen3Stephen F Austin4Julie Perrine Schaug56 Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Kobenhavn, Denmark1 Psychiatric Services Region Zealand East, Roskilde, Denmark3 Psychiatric Services Region Zealand Psychiatric Research Unit, Slagelse, Denmark1 Psychiatric Services Region Zealand East, Roskilde, Denmark1 Psychiatric Services Region Zealand East, Roskilde, Denmark3 Psychiatric Services Region Zealand Psychiatric Research Unit, Slagelse, DenmarkObjectives Clozapine is continuously underused. The existing systematic reviews addressing barriers to clozapine prescribing primarily focus on clinical staff’s attitudes and perceived barriers to prescribing. However, a preliminary literature search revealed additional literature on the subject not previously included in systematic reviews, including literature on patient perspectives. A scoping review is warranted to map the scope of primary studies on patients’ and/or clinicians’ perspectives on clozapine treatment and to identify gaps in research.Design A scoping review was designed and reported in accordance with established guidelines for scoping reviews.Data sources The electronic databases Cochrane Library, CINAHL, Web of Science, PsycINFO, MEDLINE, EMBASE, Google Scholar and two grey literature databases were searched. Furthermore, citation tracking of selected studies was undertaken.Eligibility criteria We included primary, empirical studies reporting clinicians’ and/or patients’ perspectives on clozapine treatment. No limitation was set for the year of publication or type of primary study.Data extraction and synthesis Two researchers independently screened for studies, extracted the data and coded the content. Findings were summarised visually and narratively.Results 146 studies were included. Most studies reported on patients’ or clinicians’ perspectives on active clozapine treatment or on clinicians’ perspectives on barriers to clozapine initiation in general. Three gaps in research were identified: (1) clozapine-eligible, yet clozapine-naïve, patients’ attitudes towards clozapine commencement, (2) clinicians’ reasons for clozapine withholding and perceived facilitators of clozapine treatment in specific patient-cases and (3) patient and clinician perspectives on clozapine discontinuation, continuation and rechallenge in specific patient cases.Conclusions Research on clozapine perspectives tends to repeat itself. Future studies addressing the identified gaps in evidence could provide the insights needed to optimise clozapine utilisation.https://bmjopen.bmj.com/content/15/1/e085956.full
spellingShingle Jimmi Nielsen
Erik Simonsen
Ole Jakob Storebø
Michelle Iris Jakobsen
Stephen F Austin
Julie Perrine Schaug
What is the current scope of research assessing patients’ and clinicians’ perspectives on clozapine treatment? A comprehensive scoping review
BMJ Open
title What is the current scope of research assessing patients’ and clinicians’ perspectives on clozapine treatment? A comprehensive scoping review
title_full What is the current scope of research assessing patients’ and clinicians’ perspectives on clozapine treatment? A comprehensive scoping review
title_fullStr What is the current scope of research assessing patients’ and clinicians’ perspectives on clozapine treatment? A comprehensive scoping review
title_full_unstemmed What is the current scope of research assessing patients’ and clinicians’ perspectives on clozapine treatment? A comprehensive scoping review
title_short What is the current scope of research assessing patients’ and clinicians’ perspectives on clozapine treatment? A comprehensive scoping review
title_sort what is the current scope of research assessing patients and clinicians perspectives on clozapine treatment a comprehensive scoping review
url https://bmjopen.bmj.com/content/15/1/e085956.full
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