Premium
The impact of clozapine on hospital use: a systematic review and meta‐analysis
Author(s) -
Land R.,
Siskind D.,
McArdle P.,
Kisely S.,
Winckel K.,
Hollingworth S. A.
Publication year - 2017
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12700
Subject(s) - clozapine , medicine , meta analysis , observational study , schizophrenia (object oriented programming) , psycinfo , antipsychotic , medline , psychiatry , pediatrics , political science , law
Objective The objective of this study was to perform a systematic review and meta‐analysis of studies reporting the impact of clozapine on hospital use in people with a psychotic illness. Method PubMed, EMBASE, PsycINFO and the Cochrane Schizophrenia Group Trials Register were systematically searched from inception to 12 October 2016. We included all trials and observational studies, except case reports. Results Thirty‐seven studies were included. Clozapine significantly reduced the proportion of people hospitalised compared to control medicines (RR = 0.74; 95% CI: 0.69–0.80, P < 0.001, 22 studies, n = 44 718). There were significantly fewer bed days after clozapine treatment compared to before clozapine treatment in both controlled (MD = −34.41 days; 95% CI: −68.22 to −0.60 days, P = 0.046, n = 162) and uncontrolled studies (MD = −52.86 days; 95% CI: −79.86 days to −25.86 days, P < 0.001, n = 2917). Clozapine and control medicines had a similar time to rehospitalisation (−19.90 days; 95% CI: −62.42 to 22.63 days, P = 0.36). Conclusion Clozapine treatment reduced the number of people hospitalised and the number of bed days after treatment compared with before treatment. Clozapine has the potential to reduce acute hospital use among people with treatment refractory schizophrenia.