Adherence Challenges and Long-Acting Injectable Antipsychotic Treatment in Patients with Schizophrenia

Abstract

Medication nonadherence has been associated with persistence of psychotic symptoms, relapse, and hospitalization in patients with schizophrenia. Patients with untreated psychosis are significantly less likely to achieve remission, whereas antipsychotic drug adherence has been associated with recovery. As such, adherence to antipsychotic drug treatment is a key issue for nurses and treatment team members caring for patients who typically are on chronic, progressive disease course. Long-acting injectable (LAI) anti-psychotic drugs, developed to improve adherence and provide and alternative antipsychotic drug treatment fro schizophrenia, have been associated with improved treatment outcomes including reduction of relapse rates approximately 30% and reduction in hospitalizations. However, LAI antipsychotic drugs remain underutilized in the United States despite a growing body of literature supporting positive outcomes of LAI versus oral antipsychotic drugs. Mental health nurses are in a key position to support improved adherence inpatients with schizophrenia through use of practical educational strategies that help patients, family members, and health care providers better understand and manage treatment.

Health care resource utilization and costs of California Medicaid patients with schizophrenia treated with paliperidone palmitate once monthly or atypical oral antipsychotic treatment

“…According to recent guidelines, LAIs may help patients with schizophrenia to overcome non-adherence compared to oral antipsychotics; LAIs have also been associated with reduced relapse episodes and lower rates of re-hospitalizations 6,15,16 . Several studies comparing healthcare resource utilization and associated costs between LAIs and OATs and costs of LAIs with OATs have shown the beneficial effects of LAIs, such as reduced hospitalizations, as well as better economic and clinical outcomes [17][18][19][20][21] .…”

An international survey of Psychiatric‐Mental‐Health Nurses on the content validity of the International Classification of Functioning, Disability and Health Core Sets for Schizophrenia

“…In this respect, nurses play an important role in promoting medication adherence in patients (Chang et al . ), as they may be the first to detect nonadherence and nonattendance at follow‐up visits (Morton & Zubek ). From the perspective of PMHNs, therefore, this category ( s110 Structure of brain) should probably be considered for inclusion in the Comprehensive ICF‐CS for schizophrenia.…”

The effect of motivational interviews on treatment adherence and insight levels of patients with schizophrenia: A randomized controlled study

“…Studies assert that increasing insight and strengthening medication participation of individuals diagnosed with schizophrenia require building a strong health care team‐client relationship and applying “individual” models for the change of health behavior . Morton and Zubek assert that nurses can help patients understand the importance of collaboration in treatment better. According to Baier, individual‐centered approach to therapeutic interaction with the patient conveys a message of “being together, walking on the same line.” Psychiatric nursing facilitates medical care adherence in the patient thru patient–nurse relationship based on effective communication and therapeutic relationship.…”