ArticlePsychiatric services (Washington, D.C.)2013
The effect of race-ethnicity on the comparative effectiveness of clozapine among Medicaid beneficiaries.
Article in Psychiatric services (Washington, D.C.), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Ethnic disparities in clozapine prescription for service-users with schizophrenia-spectrum disorders: a systematic review.Psychological medicine · 2022Pooled it
- Systematic Review of Real-World Treatment Patterns of Oral Antipsychotics and Associated Economic Burden in Patients with Schizophrenia in the United States.Advances in therapy · 2022Pooled it
- Positive symptoms and medication adherence in response to oral versus long-acting injectable risperidone in black, latino, and white first-episode psychosis patients.Schizophrenia research · 2025Trial
- Cultural Aspects of Health care for Ethiopian Jewish Immigrants in Israel: A Literature Review.Journal of religion and health · 2024Review
- Clozapine Use Among People With Psychotic Disorders Who Experience Specific Indications for Clozapine.The Journal of clinical psychiatry · 2024Article
- Healthcare Access for a Diverse Population with Schizophrenia Following the Onset of the COVID-19 Pandemic.Community mental health journal · 2024Article
- Article
- Variation in Psychotropic Medication Prescription for Adults With Schizophrenia in the United States.Psychiatric services (Washington, D.C.) · 2022Article
- Cluster Analysis of Clozapine Consumer Perspectives and Comparison to Consumers on Other Antipsychotics.Schizophrenia bulletin open · 2021Article
- A Retrospective Cohort Study of Acute Kidney Injury Risk Associated with Antipsychotics.CNS drugs · 2017Article
- Regional Variation in Physician Adoption of Antipsychotics: Impact on US Medicare Expenditures.The journal of mental health policy and economics · 2016Article
- Health Care Utilization and Treatment Persistence Associated with Oral Paliperidone and Lurasidone in Schizophrenia Treatment.Journal of managed care & specialty pharmacy · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
objectiveEffectiveness trials have confirmed the superiority of clozapine in schizophrenia treatment, but little is known about whether the drug's superiority holds across racial-ethnic groups. This study examined the effectiveness by race-ethnicity of clozapine relative to other antipsychotics among adult patients in maintenance antipsychotic treatment.
methodsBlack, Latino, and white Florida Medicaid beneficiaries with schizophrenia receiving maintenance treatment with clozapine or other antipsychotics between July 1, 2000, and June 30, 2005, were identified. Cox proportional hazard regression models were used to estimate associations between clozapine and race-ethnicity and their interaction; time to discontinuation for any cause was the primary measure of effectiveness.
resultsThe 20,122 members of the study cohort accounted for 20,122 antipsychotic treatment episodes; 3.7% were treated with clozapine and 96.3% with other antipsychotics. Blacks accounted for 23% of episodes and Latinos for 36%. Unadjusted analyses suggested that Latinos continued on clozapine longer than whites and that Latinos and blacks discontinued other antipsychotics sooner than whites. Adjusted analyses of 749 propensity score-matched sets of clozapine users and other antipsychotic users indicated that risk of discontinuation was lower for clozapine users (risk ratio [RR]=.45, 95% confidence interval [CI]=.39-.52), an effect that was not moderated by race-ethnicity. Times to discontinuation were longer for clozapine users. Overall risk of antipsychotic discontinuation was higher for blacks (RR=1.56, CI=1.27-1.91) and Latinos (RR=1.23, CI=1.02-1.48).
conclusionsThe study confirmed clozapine's superior effectiveness and did not find evidence that race-ethnicity modified this effect. The findings highlight the need for efforts to increase clozapine use, particularly among minority groups.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.