366. LEVERAGING DIGITAL ENABLERS TO AMPLIFY THE EVIDENCE FOR CLINICAL PRACTICE IN TREATMENT-RESISTANT SCHIZOPHRENIA

Abstract Background 50-60% of persons with schizophrenia seen in community settings have treatment-resistant schizophrenia (TRS). They have a higher incidence of comorbidities, symptoms that are more frequent and severe, and are more likely to be unemployed. Earlier treatment of TRS with clozapine is associated with better outcomes. Despite the evidence for recognising TRS and its effective treatment, diagnosis is often tardy and treatment with clozapine, the only drug approved for TRS, is deferred, further delaying the opportunity for recovery. Evidence-based knowledge applied to diagnose TRS and instil timely treatment prevents clinical entropy and can help clinicians deliver the best possible care and improve health outcomes. Dissemination of the knowledge is a critical process. It is reported that clinicians wanting to keep up with relevant journals faced examining 19 articles daily for a year. While guidelines, consolidators, and reviews along with dissemination frameworks may simplify the process, dissemination continues to be a challenge. Aims & Objectives Leverage digital enablers to disseminate the evidence for recognising and managing treatment-resistant schizophrenia. Method We leveraged digital enablers to disseminate and amplify evidence-based knowledge for recognising TRS and using clozapine early, and to overcome barriers to its use. The figure shows digital tools to (a) visualize the guidance for diagnosing and managing TRS and (b) to offer a checklist to navigate the challenges of using clozapine. The clinical constructs behind the tools are an algorithm-based approach to first-episode schizophrenia (Agid et al 2011) and a checklist compiled from published evidence (Correll et al 2022) respectively. The tools are web-enabled for wide dissemination. Results The utility of these digitally enabled visualizations of evidence, in terms of process and impact outcomes, is the subject of ongoing research. Discussion & Conclusions Practitioners rarely read, internalize, and implement evidence-based practice even when presented as clinical practice guidelines. However, the evidence constructs can readily be encoded into digital enablers. Studies have shown that guidelines, when digitally enabled, can increase practitioner adherence to them (Kwok et al 2009). Digital clinical algorithms could empower clinicians, augmenting their ability to diagnose and treat illness based on evidence and contribute to bridging the current gaps in health care (Bell et al 2017).