Understanding the Health System Conditions Affecting the Use of Long-Acting Injectable Antipsychotics in the Treatment of Schizophrenia in Clinical Practice: A US Healthcare Provider Survey

• Published in: Neuropsychiatric disease and treatment Vol. 18; pp. 1479 - 1493
• Main Authors: Zhdanava, Maryia, Starr, H. Lynn, Lefebvre, Patrick, Totev, Todor I, Shah, Aditi, Sheng, Kristy, Pilon, Dominic
• Format: Journal Article
• Language: English
• Published: Auckland Dove Medical Press Limited 01.01.2022; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Antipsychotic drugs; Antipsychotics; Caregivers; Clinical medicine; Coronaviruses; COVID-19; Dosage and administration; Drug therapy; Drugs; Health care; healthcare providers; Hospitalization; long-acting injectable antipsychotics; Mental disorders; Nurse practitioners; Nurses; Original Research; Pandemics; Patients; Practice; Prescribing; prescribing patterns; Professionals; Psychiatrists; Psychiatry; Psychologists; Psychotropic drugs; Questionnaires; Review boards; Schizophrenia; Social workers; Surveys; United States; United States > US
• ISSN: 1178-2021; 1176-6328; 1178-2021
• DOI: 10.2147/NDT.S369494

Purpose: To describe factors that enable the routine use of long-acting injectable antipsychotics (LAIs) for appropriate patients in the current clinical practice, including changes in LAI prescribing due to the COVID-19 pandemic and expectations for prescribing in 2021 in the United States (US). Methods: Frequent LAI prescribers recruited from a nationwide panel in 2020 completed an online survey regarding practice characteristics, perspectives on healthcare system conditions enabling routine use of LAIs, and prescribing patterns and changes in patterns during the COVID-19 pandemic. Results: Of 408 prescribers who completed the survey, 77.7% were physicians and 59.1% had [greater than or equal to]10 years of psychiatry practice. More than half of frequent prescribers (57.1%) reported treating >20% of their patients with schizophrenia with LAIs. The American Psychiatric Association (APA) guideline was followed by 64.0% of prescribers. Most prescribers identified poor adherence to antipsychotics as a circumstance when LAIs are recommended (94.9%) and patient/caregiver involvement in treatment decisions as a key factor impacting the decision to prescribe LAIs (97.3%). Most prescribers reported that LAI prescribing rates were unchanged in 2020 (59.8%). Similar proportions of prescribers expected no change (44.1%) or an increase (42.9%) in LAI prescribing rates in 2021. The number of patients followed, cost of treatment, and availability of staff to administer LAIs were the main driving factors identified by prescribers expecting an increase in LAI prescribing rates. Conclusion: LAIs were commonly recommended to patients with poor adherence, and patient/caregiver involvement was an important factor affecting prescribers' treatment decisions. LAI prescribing rates remained unchanged during the COVID-19 pandemic in 2020. Keywords: COVID-19, healthcare providers, long-acting injectable antipsychotics, prescribing patterns, schizophrenia