Development of the Clozaril Patient Management System.

The Clozaril Patient Management System (CPMS) has been developed to provide a 100% fail-safe system for monitoring white blood cell counts (WBCs) in patients being treated with clozapine (Clozaril/Leponex) in the United States and to provide comprehensive data collection on the incidence and development of agranulocytosis. CPMS provides a case administrator and a registered pharmacist. Their role is to support the physician by facilitating the determination of WBC's at a national laboratory and by distributing clozapine to the patient. Specific tasks of the case administrator include: keeping track of outpatient phlebotomy appointments, following up missed appointments, ensuring that WBCs are obtained and analyzed weekly by the national laboratory, following up the results of these tests, providing liason with the pharmacy, maintaining a data base for all patients receiving clozapine and conveying these data to the physician. Initial experience with this program in Cleveland is described in this paper. The characteristics of patients enrolled in CPMS, satisfaction with the program and its success in meeting predetermined objectives are described. Experience with 31 patients in this outpatient setting suggests that CPMS can be an effective, reliable system for assisting in blood monitoring of patients being treated with clozapine.