通过教育干预提高精神科住院医师对氯氮平处方的认识和舒适度
Enhancing Psychiatry Residents' Knowledge and Comfort With Clozapine Prescribing Through Educational Interventions.
摘要(中文译文)
氯氮平是治疗难治性精神分裂症最有效的抗精神病药物，但由于安全性顾虑和监测复杂性，其使用仍然不足。近期氯氮平风险评估与缓解策略（REMS）项目的终止减少了监管障碍，但将监测责任转移给了临床医生。在这一新背景下，精神科住院医师可能缺乏足够的培训和信心来安全地开具氯氮平。本研究旨在评估结构化教育干预对精神科住院医师氯氮平处方和管理知识的影响。本研究是一项采用前后设计（pre-post design）的单机构质量改进研究。参与者为PGY-1至PGY-4的精神科住院医师。参与者接受了一小时的结构化教育课程，内容涵盖氯氮平药理学、适应证、监测、不良反应及REMS终止后的管理。评估的结果包括教育课程前后的知识评估得分。采用配对t检验比较干预前后的得分以分析数据。十名住院医师完成了两项评估。平均知识得分从69.4%提高至82.8%（平均提高13.4个百分点（相对提高19.3%）；p < 0.05）。简短的针对性教育干预与精神科住院医师氯氮平处方和管理知识的提高相关。有针对性的住院医师教育可能有助于减轻氯氮平使用的障碍，尤其是在REMS终止之后。将结构化氯氮平培训纳入住院医师课程可能促进临床实践中更安全、更恰当地使用氯氮平。
Abstract
Clozapine is the most effective antipsychotic for treatment-resistant schizophrenia but remains underutilized due to safety concerns and monitoring complexity. Recent discontinuation of the Clozapine Risk Evaluation and Mitigation Strategy (REMS) program reduced regulatory barriers but shifted responsibility for monitoring to clinicians. Psychiatry residents may lack adequate training and confidence to prescribe clozapine safely in this new context. The goal of this study is to evaluate the impact of a structured educational intervention on psychiatry residents' knowledge of clozapine prescribing and management. This study was a single-institution quality improvement study using a pre-post design. Participants were psychiatry residents from PGY-1 to PGY-4. Participants underwent a one-hour structured educational session covering clozapine pharmacology, indications, monitoring, adverse effects, and post-REMS management. Outcomes assessed include knowledge assessment scores both before and after the educational session. A paired t-test comparing pre- and post-intervention scores was used to analyze the data. Ten residents completed both assessments. Mean knowledge scores increased from 69.4% to 82.8% (mean increase 13.4 percentage points (19.3% relative increase); p < 0.05). A brief, targeted educational intervention was associated with improved psychiatry residents' knowledge regarding clozapine prescribing and management. Focused resident education may help mitigate barriers to clozapine use, particularly following REMS discontinuation. Incorporating structured clozapine training into residency curricula may promote safer and more appropriate use of clozapine in clinical practice.
如何引用
AMA
Christopher Stewart, Alexander Hunter, Faith Franzwa, Quan Huynh, Jennifer Stettler, Nauman Ashraf, et al. Enhancing Psychiatry Residents' Knowledge and Comfort With Clozapine Prescribing Through Educational Interventions.. Cureus. 2026; doi:10.7759/cureus.108508.
APA
Christopher Stewart, Alexander Hunter, Faith Franzwa, Quan Huynh, Jennifer Stettler, Nauman Ashraf, et al (2026). Enhancing Psychiatry Residents' Knowledge and Comfort With Clozapine Prescribing Through Educational Interventions.. Cureus. https://doi.org/10.7759/cureus.108508
GB/T 7714
Christopher Stewart, Alexander Hunter, Faith Franzwa, Quan Huynh, Jennifer Stettler, Nauman Ashraf, et al. Enhancing Psychiatry Residents' Knowledge and Comfort With Clozapine Prescribing Through Educational Interventions.[J]. Cureus, 2026 doi:10.7759/cureus.108508.
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