Prevalence and frequency of haematological testing in patients initiating clozapine in the USA - Summary - MDSpire
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Assessment of the Frequency and Prevalence of Hematological Testing in Patients Starting Clozapine in the United States

  • By

  • Katsiaryna Bykov

  • Mufaddal Mahesri

  • Krista F Huybrechts

  • Lauren V Moran

  • Catherine S Hwang

  • Junyi Wang

  • Joyce Lii

  • Gita A Toyserkani

  • Esther H Zhou

  • Cynthia LaCivita

  • Gerald J Dal Pan

  • Aaron S Kesselheim

  • Ameet Sarpatwari

  • July 10, 2026

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Objective:

To assess the prevalence and frequency of haematological testing in patients on clozapine.

Approach:
  • Study Design: A cohort study using three US health insurance claims databases from January 2000 to March 2022.
  • Testing Assessment: Evaluated the proportion of individuals with at least one haematological test prior to clozapine initiation and the frequency of testing during specified follow-up periods.
Key Findings:
  • Atotalof62,003clozapineinitiations(meanage,36years;57%male)wereidentified,ofwhich71%wereprecededbytestingwithin60priordays.Themeantestingratewhileontherapywas2.2testsperpatientforeach30-dayperiodduringthefirst6monthsoftreatment,2.0testsper30daysduringmonths7–12,and1.5testsper30daysduringmonths13–24.
Interpretation:

Hematological testing was completed prior to clozapine initiation and during the first 6 months of treatment, but was in accordance with testing requirements thereafter.

Limitations:
  • Limited understanding of reasons for less-than-recommended testing frequency.
  • Potential underreporting of testing due to reliance on billing codes.
Conclusion:

Routine haematological testing may not consistently occur despite recommendations, warranting further investigation into adherence.

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