Determinants of patient satisfaction in clozapine users: results from the Clozapine International Consortium (CLOZIN)

Clozapine is highly effective for treatment-resistant schizophrenia but is underutilized due to patient and clinician-related concerns. Little is known about the general level of patient satisfaction with clozapine and determinants thereof. We therefore explored determinants of patient satisfaction with clozapine in individuals diagnosed with schizophrenia spectrum disorders (SSDs). Cross-sectional data from 480 clozapine users were used to examine demographic and clinical factors, including symptom severity, treatment response, and adverse drug reactions (ADRs). Patient satisfaction was self-rated on a scale of 1 to 10. Results showed a mean satisfaction score of 7.4 (SD = 1.9), with significant associations between satisfaction and treatment response (B = 0.42, R² = 0.19, p = 3.9 × 10⁻¹⁸), symptom severity (B = 0.10, R² = 0.05, p = 2.06 × 10<sup>-9</sup>), occurrence of ADRs (B = -0.16, R² = 0.06, p = 3.2 × 10<sup>-5</sup>), and recreational drug use (B = -1.32, R² = 0.05, p = 2.09 × 10<sup>-4</sup>). Hypersalivation and prolonged sleep duration were the only ADRs linked to lower satisfaction (B = -0.72, R² = 0.06, p = 3.5 × 10<sup>-5</sup> and B = -0.57, R² = 0.04, p = 1.4 × 10<sup>-3</sup>, respectively). Despite concerns about ADRs, treatment effectiveness showed a stronger association with patient satisfaction among clozapine users than the occurrence of ADRs. In conclusion, our findings suggest that strategies aimed at bolstering clozapine's effectiveness may help counter worldwide underprescription rates of clozapine in patients with SSDs.

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Publication Details

Journal
Schizophrenia
Published
2025-02-23
DOI
https://doi.org/10.1038/s41537-025-00570-9
Citations
7
Primary Topic
Schizophrenia research and treatment
Type
article
Field-Weighted Citation Impact
10.30

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Determinants of patient satisfaction in clozapine users: results from the Clozapine International Consortium (CLOZIN)

Selene Veerman, Erwin Bekema, Purificación López-Peña, Carla Lou Morgenroth et al.
7 citations
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Schizophrenia research and treatment
10.30
article

Determinants of patient satisfaction in clozapine users: results from the Clozapine International Consortium (CLOZIN)

Selene Veerman, Erwin Bekema, Purificación López-Peña, Carla Lou Morgenroth, Robert A. Bittner, Tero Hallikainen, Tatiana Oviedo-Salcedo, Clemente García‐Rizo, Lorea Mar‐Barrutia, Christos Pantelis, Eila Repo‐Tiihonen, Yavuz Ayhan, Jan Bogers, Anna Mané, Emilio Fernández-Egea, Jurjen J. Luykx, Edwin Beld, Jim van Os, Amy Jongkind, Alde Bouhuis, Thomas Görlitz, Christa Hohoff, Cynthia Okhuijsen‐Pfeifer, Dan Cohen, Cecilia Casetta, Bernhard T. Baune, René S. Kahn, Benedicto Crespo‐Facorro, Marta Bosia, Francesca Serio, Gökhan Yoca, Javier Vázquez-Bourgón, Francesca Vairano, Roberto Cavallaro, Marina Garriga, Giacomo Mercuriali, Tania Rivera Baltanás, Monika Edlinger, Marije de Vos, Esteban Sepúlveda, A. Elif Anıl Yağcıoğlu, Mishal Qubad, Ana González‐Pinto, Stephan Ripke, Nini de Boer, Stefan Gutwinski, Armando D’Agostino, Hanneke van Beek, Lourdes Martorell, Ian Everall, Wouter Alink, Mirko Manchia, Ellen Jeger-Land, Koen P. Grootens, Johannes Schneider‐Thoma, Pasquale Paribello, Jacopo Sapienza, Ahmet Müderrisoğlu, Stefanie Schreiter, Alba Toll, Marco Zierhut, Francesca Martini, Maarten Bak, Marte van der Horst, Jari Tiihonen, Dragana Ignjatović Ristić, Mike Veereschild, Elias M. Wagner, Marco Spangaro, Elisabet Vilella, Federico Wiedenmann, Heli Tuppurainen, Chad Bousman, Carlos Spuch, Aygün Ertuğrul, Markku Lähteenvuo, Bianca Sánchez-Barbero, Claudia Ovejas-Catalán, Paloma Fuentes-Pérez, Eric P. Zorrilla, İbrahim Mert Erdoğan, Alkomiet Hasan, Carmen Fernandez de Pinedo, Mariken de Koning, Melih O. Babaoğlu, Ivona Novakovic, Harm J. Gijsman, Giovanni Boido
article en
7 citations

Abstract

Clozapine is highly effective for treatment-resistant schizophrenia but is underutilized due to patient and clinician-related concerns. Little is known about the general level of patient satisfaction with clozapine and determinants thereof. We therefore explored determinants of patient satisfaction with clozapine in individuals diagnosed with schizophrenia spectrum disorders (SSDs). Cross-sectional data from 480 clozapine users were used to examine demographic and clinical factors, including symptom severity, treatment response, and adverse drug reactions (ADRs). Patient satisfaction was self-rated on a scale of 1 to 10. Results showed a mean satisfaction score of 7.4 (SD = 1.9), with significant associations between satisfaction and treatment response (B = 0.42, R² = 0.19, p = 3.9 × 10⁻¹⁸), symptom severity (B = 0.10, R² = 0.05, p = 2.06 × 10<sup>-9</sup>), occurrence of ADRs (B = -0.16, R² = 0.06, p = 3.2 × 10<sup>-5</sup>), and recreational drug use (B = -1.32, R² = 0.05, p = 2.09 × 10<sup>-4</sup>). Hypersalivation and prolonged sleep duration were the only ADRs linked to lower satisfaction (B = -0.72, R² = 0.06, p = 3.5 × 10<sup>-5</sup> and B = -0.57, R² = 0.04, p = 1.4 × 10<sup>-3</sup>, respectively). Despite concerns about ADRs, treatment effectiveness showed a stronger association with patient satisfaction among clozapine users than the occurrence of ADRs. In conclusion, our findings suggest that strategies aimed at bolstering clozapine's effectiveness may help counter worldwide underprescription rates of clozapine in patients with SSDs.

SchizophreniaVol. 11(1)
Goethe University Frankfurt (DE), Universidad de Cantabria (ES), University of Kragujevac (RS), Innsbruck Medical University (AT), Vita-Salute San Raffaele University (IT), The University of Melbourne (AU), University of Cagliari (IT), University of Augsburg (DE), University of Milan (IT), Utrecht University (NL), Tilburg University (NL), University of Münster (DE), Florey Institute of Neuroscience and Mental Health (AU), Instituto de Salud Carlos III (ES), Niuvanniemi Hospital (FI), Institut Pere Mata (ES), University Medical Center Utrecht (NL), LMU Klinikum (DE), Maastricht University (NL), Humboldt-Universität zu Berlin (DE), Centro de Investigación Biomédica en Red de Salud Mental (ES), Institut de Recerca Biomèdica Catalunya Sud (ES), Hospital Universitario Araba (ES), Instituto de Investigación Marqués de Valdecilla (ES), Hospital Clínic de Barcelona (ES), GGZ Rivierduinen (NL), University Hospital Frankfurt (DE), Parc de Salut (ES), Instituto de Biomedicina de Sevilla (ES), GGZ inGeest (NL), GGNet (NL), Arkin (NL), Mondriaan GGZ (NL), Reinier van Arkel (NL), Amsterdam University Medical Centers (NL), Clinical Centre of Kragujevac (RS), Pro Persona (NL), Melbourne Health (AU), Kırıkkale University (TR), Technical University of Munich (DE), Hacettepe University (TR), Universitat de Barcelona (ES), Freie Universität Berlin (DE), Charité - Universitätsmedizin Berlin (DE), Universidad de Sevilla (ES), Ludwig-Maximilians-Universität München (DE)
Universitair Medisch Centrum Utrecht
Good health and well-being
Openalex Percentile: Top 2%
Schizophrenia research and treatment
10.30
DOIOpen Access PDFOpenAlex
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