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Objective <p>This study assessed the real-world adoption of a point-of-care fingerstick testing device for blood monitoring for absolute neutrophil count in clozapine-treated patients at two outpatient psychiatric clinics.</p> Methods <p>Adoption rates and acceptability were assessed with electronic health record data and patient surveys. Implementation determinants were identified via rapid thematic analysis of staff interviews.</p> Results <p>22% (10/45) of clozapine-treated patients at a specialized psychosis treatment program and 60% (120/199) at a community mental health center used fingerstick testing at least once. Among survey respondents (<i>n</i> = 86), infrequent users (36%) and non-users (56%) cited not wanting to change care, and perceived greater pain/inconvenience with fingerstick testing versus venipuncture. Non-users had taken clozapine for about seven years longer than those who tried fingerstick testing. Implementation barriers included provider burden and lack of reimbursement mechanisms; facilitators included designated personnel for test administration.</p> Conclusions <p>Successful implementation of fingerstick testing for clozapine safety monitoring requires planning to address patient preferences, staffing logistics, and sustainable financing strategies.</p>

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Implementing Point-of-Care Fingerstick Testing for Clozapine Safety Monitoring in Outpatient Psychiatry: A Convergent Mixed Methods Study

  • 期刊论文

  • 发表日期：

    2026年3月2日

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  • Cheryl Y. S. Foo,
  • Carol Lim,
  • Catherine J. Leonard,
  • Sarah A. MacLaurin,
  • Corinne Cather,
  • Abigail L. Donovan,
  • Oliver Freudenreich

摘要

Objective

This study assessed the real-world adoption of a point-of-care fingerstick testing device for blood monitoring for absolute neutrophil count in clozapine-treated patients at two outpatient psychiatric clinics.

Methods

Adoption rates and acceptability were assessed with electronic health record data and patient surveys. Implementation determinants were identified via rapid thematic analysis of staff interviews.

Results

22% (10/45) of clozapine-treated patients at a specialized psychosis treatment program and 60% (120/199) at a community mental health center used fingerstick testing at least once. Among survey respondents (n = 86), infrequent users (36%) and non-users (56%) cited not wanting to change care, and perceived greater pain/inconvenience with fingerstick testing versus venipuncture. Non-users had taken clozapine for about seven years longer than those who tried fingerstick testing. Implementation barriers included provider burden and lack of reimbursement mechanisms; facilitators included designated personnel for test administration.

Conclusions

Successful implementation of fingerstick testing for clozapine safety monitoring requires planning to address patient preferences, staffing logistics, and sustainable financing strategies.