Impact of COVID-19 quarantines on clozapine-induced constipation: Experience of utilizing a clozapine-induced constipation protocol at a state forensic psychiatric facility

• Main Authors: Bridgette M. Gleisner, PharmD (Author), O. Greg Deardorff, PharmD, BCPP (Author), Yifei Liu, BS Pharm, PhD (Author), Megan G. Trout, PharmD (Author), Joshua R. Wood, PharmD (Author), Roger W. Sommi, PharmD, BCPP, FCCP (Author), Niels C. Beck, PhD (Author)
• Format: Book
• Published: American Association of Psychiatric Pharmacists, 2024-02-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2168-9709; 10.9740/mhc.2024.02.068
• Keywords: clozapine; constipation; schizophrenia; covid-19; quarantine; protocol; bristol stool chart; Neurosciences. Biological psychiatry. Neuropsychiatry; RC321-571; Pharmacy and materia medica; RS1-441
• Source: Mental Health Clinician, Vol 14, Iss 1, Pp 68-72 (2024)

Objective Since 2017, Fulton State Hospital (FSH) has implemented a clozapine-induced constipation protocol. In March 2020, FSH initiated unit quarantines to minimize the spread of coronavirus disease (COVID-19). The objective of this study was to evaluate the impact of these quarantines on medical referrals for constipation, the Bristol Stool Chart ratings, utilization of as-needed (PRN) laxatives, and adherence rates with scheduled constipation medication regimens. Methods Patients on the clozapine-induced constipation protocol from May 1, 2019 to December 31, 2020, were included, with 10-month pre- and mid-quarantine implementation. Data collected included patient demographics, primary psychiatric diagnosis, and outcome variables. Descriptive statistics and paired t-tests were performed. Results A total of 31 patients were included. Most were male (93.5%), with a median age of 40 years. The most common primary diagnosis was schizophrenia. Compared with the pre-quarantine implementation period, there were fewer medical referral contacts per person, less use of PRN laxatives, and slightly lower adherence rates to scheduled constipation medication regimens during the mid-quarantine implementation period. Conclusion Compared with the pre-quarantine implementation period, there were fewer medical referrals per person during the mid-quarantine implementation period.