Confident Clozapine Prescribing: Motivating Clinicians to Address Racial and Ethnic Disparities in Clozapine Utilization-View Presentation

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The session, titled "Confident Clozapine Prescribing: Motivating Clinicians to Address Racial and Ethnic Disparities in Clozapine Utilization," aimed to address underutilization of clozapine, particularly among racial and ethnic minorities. Chaired by Claire Holderness, it featured speakers Drs. Laura Clark, Jean-Marie Bradford, and Scott Stroop. They covered diverse topics about clozapine, including its management in patients with constitutional neutropenia, a condition prevalent in certain ethnic groups. Despite its status as a potentially life-saving treatment for treatment-resistant schizophrenia, clozapine is underutilized in the U.S., where only 4-5% of schizophrenia patients receive it, compared to over 20% in some industrialized countries.<br /><br />The presentations highlighted racial disparities, with African-American and Hispanic patients less likely to receive clozapine. Factors contributing to these disparities include implicit bias, systemic barriers, and issues with healthcare access. Successful initiatives, like the New York State campaign, have improved clozapine prescribing rates through education and resources.<br /><br />Dr. Clark discussed neutropenia, a barrier to clozapine usage, and how benign ethnic neutropenia (BEN) doesn't increase the risk of clozapine-induced agranulocytosis. Clinical vignettes illustrated real-world challenges and outcomes in managing treatment-resistant schizophrenia with clozapine.<br /><br />Dr. Stroop emphasized the need for better clozapine education among clinicians, and the difficulties posed by clozapine's side effects, highlighting the need for comprehensive care structures. The discussion also touched upon implicit bias in prescribing practices, suggesting that ongoing education and institutional protocols could mitigate these disparities.

Keywords

Clozapine

Racial disparities

Ethnic minorities

Treatment-resistant schizophrenia

Neutropenia

Implicit bias

Healthcare access

Prescribing practices

Benign ethnic neutropenia

Comprehensive care

Clinician education

Systemic barriers