Community-Based Service Use After Clozapine Treatment: A Mirror-Image Analysis of Public Claims Data

• Published in: Psychiatric services (Washington, D.C.) Vol. 74; no. 10; pp. appips20220471 - 1107
• Main Authors: Sarpal, Deepak K, Suh, Kangho, Bian, Kaiqi, Ko, Pingjui, Gannon, Jessica M, Jhon, Peter, Chengappa, K N Roy
• Format: Journal Article
• Language: English
• Published: United States American Psychiatric Publishing, Inc 01-10-2023
• Subjects: Data collection; Medical treatment; Psychiatry; Psychosis; Schizophrenia; Rehabilitation/psychosocial; Inpatient treatmen; Clozapine; Treatment-resistant schizophrenia; Community residences/supported housing; Psychopharmacology/psychosocial aspects
• ISSN: 1075-2730; 1557-9700
• DOI: 10.1176/appi.ps.20220471

Although clozapine demonstrates unique efficacy for treatment-resistant schizophrenia, its impact on community-based services remains largely underexplored. The authors examined changes in use of community-based services after clozapine treatment among a sample of 163 patients with schizophrenia by using public claims data in Allegheny County, Pennsylvania. Mirror-image analyses of service utilization were used to compare the 180-day period before treatment initiation with the 180-day period that began after 6 months of adherent treatment, accounting for age, race, and gender. Across demographic variables, clozapine treatment was associated with increased use of community-based services and decreased use of psychiatric inpatient services (p<0.05, Bonferroni corrected), suggesting that clozapine treatment shifts service needs from emergency care to community-based care and recovery.