1. Developing a validated methodology for identifying clozapine treatment periods in electronic health records.
- Author
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Segev, Aviv, Govind, Risha, Oloyede, Ebenezer, Morrin, Hamilton, Jewell, Amelia, Jones, Rowena, Mangiaterra, Laura, Bonora, Stefano, Iqbal, Ehtesham, Stewart, Robert, Broadbent, Matthew, and MacCabe, James H.
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ELECTRONIC health records , *ANTIPSYCHOTIC agents , *DATABASES , *CLOZAPINE , *BLOOD testing - Abstract
Background: Clozapine is the only recommended antipsychotic medication for individuals diagnosed with treatment-resistant schizophrenia. Unfortunately, its wider use is hindered by several possible adverse effects, some of which are rare but potentially life threatening. As such, there is a growing interest in studying clozapine use and safety in routinely collected healthcare data. However, previous attempts to characterise clozapine treatment have had low accuracy. Aim: To develop a methodology for identifying clozapine treatment dates by combining several data sources and implement this on a large clinical database. Methods: Non-identifiable electronic health records from a large mental health provider in London and a linked database from a national clozapine blood monitoring service were used to obtain information regarding patients' clozapine treatment status, blood tests and pharmacy dispensing records. A rule-based algorithm was developed to determine the dates of starting and stopping treatment based on these data, and more than 10% of the outcomes were validated by manual review of de-identified case note text. Results: A total of 3,212 possible clozapine treatment periods were identified, of which 425 (13.2%) were excluded due to insufficient data to verify clozapine administration. Of the 2,787 treatments remaining, 1,902 (68.2%) had an identified start-date. On evaluation, the algorithm identified treatments with 96.4% accuracy; start dates were 96.2% accurate within 15 days, and end dates were 85.1% accurate within 30 days. Conclusions: The algorithm produced a reliable database of clozapine treatment periods. Beyond underpinning future observational clozapine studies, we envisage it will facilitate similar implementations on additional large clinical databases worldwide. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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