Fairview Pharmacy Clozapine Monitoring Program

Better Persistency REMS management* with Pharmacy Support The complex REMS requirements for clozapine therapy are managed Fairview Pharmacy Services developed the pharmacy-driven by the pharmacy team, including: clozapine monitoring program to support the University of Minnesota Psychiatry Clinic and its patients receiving clozapine. Patients enrolled • Enrollment as a certified in the program are significantly more persistent than patients who are clozapine REMS pharmacy not enrolled. • REMS registration for each % patient 70 • Assessment and documentation 4X of lab values (notification to prescriber if values are out of range ) • Dispensing of clozapine per REMS requirements Almost 4 times more Nearly 70% remain • Communication of any issues likely to be persistent persistent with their with prescriber after just 90 days clozapine therapy

Overview and Challenges Patient lab/refills Clozapine is an atypical antipsychotic most commonly used for Pharmacists coordinate the complex treatment of patients with schizophrenia who have not adequately schedule of lab draws and refills: responded to first-line antipsychotic treatment. Challenges of clozapine use include: • Risk of severe neutropenia, which can lead to serious infection First 6 months: and death 1X per week draws/refills • Risk Evaluation and Mitigation Strategy (REMS) requirements, which are complex and time–consuming for clinic staff • The high frequency of laboratory monitoring – while many patients 7-12 months: have limited means of transportation 1X every 2 weeks draws/refills

Pharmacy-based strategies that 1 year and beyond: support psychiatric health 1X per month draws/refills Fairview Pharmacy offers comprehensive services for the successful use of clozapine including:

About Fairview Pharmacy Enrollment Coordination of Patient support On-site Fairview Pharmacy Services is a of patients all laboratory services including pharmacists at national leader in the development in clozapine services - reminder calls the University monitoring and including mobile for refills and lab of Minnesota of ambulatory pharmacy-related REMS programs, phlebotomy team draws, Medication Psychiatry services. In addition to more than and ongoing for home lab draws Therapy Clinic (Riverside management - and recording Management 35 retail pharmacies, we offer a Campus) who wide range of service programs of the complex of lab results (MTM) interface with REMS into REMS and consultations, and patients and the designed to optimize health requirements for electronic health recommendations care team. outcomes and manage costs. clozapine therapy. record systems. for appropriate follow-up. For more information visit fairviewrx.org.

Fairview Pharmacy’s clozapine monitoring services are available to any clinic that prescribes clozapine. Call 612-273-1300 to learn more about program options.

* REMS, or Risk Evaluation and Mitigation Strategy, is a program required by the FDA to ensure that the benefits of a drug outweigh the risks. The FDA has determined that a REMS is necessary for clozapine.