Table 3 Association between knowledge and attitude and academic position
Questions | Had an academic position | No academic position | p-value | ||||
|---|---|---|---|---|---|---|---|
Disagree | Don’t know | Agree | Disagree | Don’t know | Agree | ||
Never started any patient on Clozapine | 48 (100) | 0 | 0 | 210 92.9) | 0 | 16 (7.1) | 0.084* |
Lack of belief in the greater effectiveness of clozapine | 35 (72.9) | 10 (20.8) | 3 (6.3) | 166 (73.5) | 47 (20.8) | 13 (5.8) | 0.991** |
Lack of access to crisis/home treatment team | 18 (37.5) | 3 (6.5) | 27 (56. 5) | 113 (50.0) | 3 (1.3) | 110 (48. 7) | 0.047 |
don’t believe in the safety of clozapine | 9 (18.8) | 23 (47.9) | 16 (33.3) | 81 (35.8) | 96 (42.5) | 49 (21.7) | 0.048 |
I prefer to use other approaches before starting clozapine | 18 (37.5) | 0 | 30 (62.5) | 57 (25.2) | 2 (0.9) | 167 (73.9) | 0.187* |
Access to counseling services | 0 | 0 | 48 (100) | 8 (3.6) | 0 | 217 (96.4) | 0.358 |
It is difficult to start treatment with clozapine | 7 (14.6) | 0 | 41 (85.4) | 41 (18.1) | 0 | 185 (81.7) | 0.678* |
There is conflicting information about its safety and efficacy | 36 (75.0) | 0 | 12 (25.0) | 137 (60.6) | 5 (2.2) | 84 (37.2) | 0.144* |
Reluctant to prescribe due to life-threatening complications | 30 (62.5) | 0 | 18 (37.5) | 134 (59.3) | 3 (1.3) | 89 (39.4) | 0.928* |
Concerns about the increased risk of clozapine-related drug interactions | 31 (64.6) | 0 | 17 (35.4) | 130 (57.5) | 3 (1.3) | 93 (41.2) | 0.730* |
Financial barriers to prescribing | 21 (43.8) | 1 (2.1) | 26 (54.2) | 78 34.5) | 0 | 148 (65.5) | 0.059* |
It is associated with increased death than other antipsychotics | 35 (72.9) | 3 (6.3) | 10 (20.8) | 160 (70.8) | 29 (12.8) | 37 (16.4) | 0.377 |
There is delayed use due to no viable alternative | 29 (61.7) | 2 (4.3) | 16 (34.0) | 120 (54.8) | 13 (5.9) | 86 (39.3) | 0.671 |
Not easy to identify suitable patients | 23 (48.9) | 3 (6.4) | 21 (44.7) | 85 (38.8) | 3 (1.4) | 131 (59.8) | 0.033 |
Lack of belief in the safety of clozapine | 31 (65.9) | 8 (17.0) | 8 (17.0) | 139 (63.5) | 59 (26.9) | 21 (9.6) | 0.173 |
It is associated with reduced alcohol and drug use | 9 (19.2) | 17 (36.2) | 21 (44.7) | 25 (11.4) | 98 (44.8) | 96 (43.8) | 0.290 |
It is associated with Signiant reduced suicide risk | 6 (12.8) | 7 (14.9) | 34 (72.3) | 19 (8.7) | 49 (22.4) | 151 (68.9) | 0.410 |
Requires 5 years before starting clozapine | 2 (4.3) | 37 (78.7) | 8 (17.0) | 0 | 196 (89.5) | 23 (10.5) | 0.012 |
The risk of agranulocytosis remains the same throughout | 8 (17.0) | 4 (8.5) | 35 (74.5) | 34 (15.5) | 13 (5.9) | 172 (78.5) | 0.764 |
Had good exposure as a trainee to use clozapine | 11 (23.9) | 5 (10.9) | 30 (65.2) | 81 (36.9) | 27 (12.3) | 111 (50.7) | 0.178 |
Welcome to learn more about updating clozapine | 3 (6.4) | 1 (2.1) | 43 (91.5) | 11 (5.1) | 0 | 207 (94.9) | 0.146* |
Challenging to get patients/careers to agree | 23 (48.9) | 1 (2.1) | 23 (48.9) | 109 (49.8) | 0 | 110 (50.2) | 0.242* |
Lack of first-hand experience of the superiority of clozapine | 17 (36.2) | 0 | 30 (63.8) | 28 (12.8) | 2 (0.9) | 189 (86.3) | 0.001* |
Clozapine is not suitable for young patients | 37 (78.7) | 3 (6.4) | 7 (14. 9) | 164 (74.9) | 34 (15.5) | 21 (9.6) | 0.162 |
Clozapine is more widely used than what is portrayed in literature | 29 (61.7) | 12 (25.5) | 6 (12.8) | 110 (50.2) | 80 (36.5) | 29 (13.2) | 0.311 |