Support for near-patient testing in treatment-resistant schizophrenia

HORIBA UK, Medical has received recognition for a new partnership with Britannia Pharmaceuticals and Northumberland Tyne & Wear Mental Health Trust (NTW) for community-based near-patient testing for treatment-resistant schizophrenia patients.

Highly commended within the ‘Best Healthcare Provider Partnership with the NHS’ category at the recent HSJ Partnership Awards, the installation of HORIBA’s Yumizen H500 point-of-care haematology analysers at 14 of its mental health clinics has enabled NTW to improve its model for clozapine dispensing. Schizophrenia patients now have an effective ‘one-stop shop’ for blood testing and dispensing, with improved patient outcomes evident.

Clozapine, supplied as Denzapine by Britannia Pharmaceuticals, is indicated in treatment-resistant schizophrenic patients and in schizophrenia patients who have severe, untreatable neurological adverse reactions to other antipsychotic agents, including atypical antipsychotics. Denzapine is also indicated in psychotic disorders occurring during the course of Parkinson's disease, in cases where standard treatment has failed.

This prescription medicine can cause agranulocytosis resulting in serious infections and even death. Therefore, prior to treatment initiation, physicians must ensure that the patient has not previously experienced an adverse haematological reaction to clozapine that necessitated its discontinuation. Prescriptions should not be issued for periods longer than the interval between two blood counts.

Before clozapine can be dispensed, white blood cell count (WBC) and an absolute neutrophil count (ANC) are required to ensure patient safety. The NTW clinics operate a traffic light dispensing system, meaning that patients not having a blood test or without a confirmed sufficiently high WBC or high ANC cannot receive their clozapine prescription. This can cause subsequent stress and anxiety for the patient.

Having the Yumizen H500 delivering a full blood count with five-part WBC differential from just 20 μL of whole blood within two minutes at the NTW clinics has helped to alleviate stress, as more patients can now receive their prescription immediately in a single visit to the clinic. Furthermore, as the Yumizen H500 can analyse capillary blood samples obtained by a simple finger prick, this can be used as a last resort as an easier means of taking blood from mental health patients who may be particularly anxious, or who are drug users.