Assessing Clinical Practice Patterns in Treatment-Resistant Schizophrenia

Goal: To assess physicians’ practice patterns in recognition, management, and knowledge of emerging treatments for treatment-resistant schizophrenia (TRS).

Methods:

•    A 26-question assessment survey was made available online to physicians without monetary compensation or charge on March 9, 2018, and data were collected until April 5, 2018 

•    Respondent confidentiality was maintained and responses were de-identified and aggregated prior to analysesResults: Data were collected for the 467 psychiatrists and 188 primary care physicians (PCPs).

Findings were:

•    Neurobiology: 47% of psychiatrists and 26% of PCPs correctly answered questions regarding association of higher glutamate levels in certain areas of the brain in TRS

•    Risk factors: 69% of psychiatrists and 38% of PCPs were able to identify risk factors for TRS

•    Adequate treatment/patient identification: 55% of psychiatrists and 30% of PCPs were aware of adequate treatment for determining whether a patient is treatment resistant; 73% of psychiatrists and 49% of PCPs were able to correctly select assessment tools and tests to evaluate whether a patient has TRS

•    Current management: On average, 53% of psychiatrists and 30% of PCPs were able to tailor currently available treatments such as clozapine and electroconvulsive therapy in patient cases of TRS

•    Awareness on emerging treatments: 72% of psychiatrists and 61% of PCPs were aware of agents studied as monotherapy for TRS, however, only 28% of psychiatrists and 33% of PCPs were able to correctly identify their mechanisms of actionConclusions: This educational research yielded important insights into clinical practice gaps in TRS.