Table 4 Association between knowledge and attitude and work experience

Never started any patient on lozapine

130 (90.3)

0

14 (9.7)

132 (100)

0

0

< 0.0001*

Lack of belief in the greater effectiveness of clozapine

93 (64.6)

39 (27.1)

12 (8.3)

112 (84.8)

18 (13.6)

2 (1.5)

< 0.0001*

Lack of access to crisis/home treatment team

65 (45.1)

4 (2.8)

75 (52.1)

66 (50.0)

2 (1.5)

64 (48.5)

0.611

don’t believe in the safety of clozapine

32 (22.2)

76 (52.8)

36 (25.0)

60 (45. 5)

43 (32.6)

29 (21.9)

< 0.0001

I prefer to use other approaches before starting clozapine

42 (29.2)

2 (1.4)

100 (69.4)

34 (25.8)

0

98 (74.2)

0.381*

Access to counseling services

6 (4.2)

0

138 (95.8)

2 (1.5)

0

129 (98.5)

< 0.174

It is difficult to start treatment with clozapine

15 (10.4)

0

129 (89.6)

36 (27.3)

0

96 (72.7)

< 0.0001

There is conflicting information about its safety and efficacy

84 (58.3)

2 (1.4)

58 (40.3)

91 (68.9)

3 (2.3)

38 (28.8)

< 0.132

Reluctant to prescribe due to life-threatening complications

73 (50.7)

0

71 (49.3)

95 (71.9)

3 (2.3)

34 (25.8)

< 0.0001*

Concerns about the increased risk of clozapine-related drug interactions

76 (52.8)

1 (0.7)

67 (46.5)

87 (65.9)

2 (1.5)

43 (32.6)

< 0.037*

Financial barriers to prescribing

50 (34.7)

1 (0.7)

93 (64.6)

53 (40.5)

0

78 (59.5)

0.383

It is associated with increased death than other antipsychotics

88 (61.1)

25 (17.4)

31 (21.5)

110 (83.9)

7 (5.3)

14 (10.7)

< 0.0001

There is delayed use due to no viable alternative

63 (45.7)

8 (5.8)

67 (48.6)

88 (67.7)

6 (4.6)

36 (27.7)

0.001*

Not easy to identify suitable patients

50 (36.2)

5 (3.6)

83 (60.1)

60 (46.2)

1 (0.8)

69 (53.1)

0.1

Lack of belief in the safety of clozapine

72 (52.6)

45 (32.9)

20 (14.6)

99 (76.2)

22 (16.9)

9 (6.9)

< 0.0001

It is associated with reduced alcohol and drug use

18 (13.0)

84 (60.9)

36 (26.1)

16 (12.3)

30 (23.1)

84 (64.6)

< 0.0001

It is associated with Signiant reduced suicide risk

12 (8.7)

41 (29.7)

85 (61.6)

13 (10.0)

14 (10.8)

103 (79.2)

0.001

Requires 5 years before starting clozapine

1 (0.7)

127 (92.0)

10 (7.3)

1 (0.8)

108 (83.1)

21 (16.2)

0.04*

The risk of agranulocytosis remains the same throughout

23 (16.7)

12 (8.7)

103 (74.6)

21 (16.2)

6 (4.6)

103 (79.2)

0.396

I had good exposure as a trainee to using clozapine

68 (49.3)

24 (17.4)

46 (33.3)

24 (18.6)

9 (6.9)

96 (74.4)

< 0.0001*

Welcome to learn more about updating clozapine

9 (6.6)

0

128 (93.4)

6 (4.6)

1 (0.8)

123 (94.6)

0.514

Challenging to get patients/careers to agree

50 (36.5)

0

87 (63.5)

83 (63.9)

1 (0.8)

46 (35.4)

< 0.0001*

Lack of first-hand experience of the superiority of clozapine

15 (10.9)

2 (1.5)

121 (87.7)

30 (23.1)

0

100 (76.9)

< 0.008

Clozapine is not suitable for young patients

97 (70.3)

23 (16.7)

18 (13.0)

105 (80.8)

15 (11.5)

10 (7.7)

0.127

Clozapine is more widely used than what is portrayed in literature

50 (36.2)

70 (50.7)

18 (13.0)

90 (69.2)

25 (19.2)

15 (11.5)

< 0.0001