Changes in attitude towards LAI antipsychotic maintenance treatment: A two-year follow-up study

Pietrini, Francesco; D’Anna, Giulio; Tatini, Lorenzo; Talamba, Gabriela Alina; Andrisano, Costanza; Calderani, E.; Manetti, Mara; Prodi, Paolo Rossi; Ricca, Valdo; Ballerini, Andrea

doi:10.1016/j.eurpsy.2018.06.002

Cited by 17 publications

(21 citation statements)

References 47 publications

(124 reference statements)

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“…Poor adherence to medication is a significant problem in the treatment of schizophrenia, and is a frequent cause of illness relapse, hospitalisation and worsening of the patient's symptoms and function [1]. Several studies have investigated the pros and cons of oral medication versus long acting medication through injections (LAI) [2][3][4][5][6][7][8][9]. Compared to oral antipsychotic treatment, LAI significantly increases the time to symptomatic relapse and re-hospitalisation and reduces mortality [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Patients’ perspectives on three-monthly administration of antipsychotic treatment with paliperidone palmitate – a qualitative interview study

Rise

Stølan

Erdner

et al. 2020

Nordic Journal of Psychiatry

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Introduction: Three-monthly dosage of paliperidone palmitate entails longer time to relapse after discontinuation, is similarly tolerable and safe compared to monthly injections of paliperidone palmitate and is beneficial for the caregivers. However, few studies have so far explored in depth the patients' experiences with paliperidone palmitate medication every three months, or with switching from monthly to three-monthly injections of paliperidone palmitate. Material and methods: A qualitative study based on individual interviews with persons with schizophrenia who receive three-monthly paliperidone palmitate in Norway, Sweden and Denmark. Data was analysed according to qualitative content analysis. Results: Twenty-four patients, 16 men and 8 women, took part in individual interviews. The patients' mental health care professionals mainly recommended the switch to three-monthly paliperidone palmitate, and few or no disadvantages were described. According to the patients, three-monthly paliperidone palmitate had several advantages, such as less frequent injections, less administration and planning and less focus on the illness. In addition, the participants described feeling more stability, being more physically and socially active, and that improvement processes were supported. For some, the use involved practical and economic challenges, and some worried whether the medicine 'wore off' before the next injection. According to the patients, switching to three-monthly paliperidone palmitate did not influence the frequency or content of patients' interaction with health care professionals. Conclusion: Switching from monthly to three-monthly injections with paliperidone palmitate seems to be experienced as advantageous for patients with schizophrenia.

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Section: Introductionmentioning

confidence: 99%

Patients’ perspectives on three-monthly administration of antipsychotic treatment with paliperidone palmitate – a qualitative interview study

Rise

Stølan

Erdner

et al. 2020

Nordic Journal of Psychiatry

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“…Although some large randomized controlled trials (RCTs) have not shown significant difference in efficacy between LAIs and oral antipsychotics,5,6 the experimental nature of RCTs, such as enhanced compliance and selective recruitment, might explain these results. In naturalistic settings, several studies have demonstrated the superior effectiveness of LAIs over oral antipsychotics in improving quality of life, reducing hospitalization rates and treatment discontinuation;7,8 however, LAIs remain underutilized in clinical practice 9,10. To date, patients’ and psychiatrists’ attitudes toward LAIs that may affect clinical practice have been investigated 11,12.…”

Section: Introductionmentioning

confidence: 99%

Attitudes toward long-acting injectable antipsychotics among patients with schizophrenia in Japan

Sugawara¹,

Kudo²,

Ishioka³

et al. 2019

NDT

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BackgroundLong-acting injectable antipsychotics (LAIs) are regarded as an important alternative to oral medication for patients with schizophrenia. However, LAIs remain under-utilized in clinical practice.AimsThe aims of this investigation were to 1) obtain information on patients’ attitudes toward LAIs and 2) assess factors associated with patients’ acceptance of LAIs, and 3) identify predictors of the discrepancy between patients and referring psychiatrists’ opinions regarding the appropriateness for LAIs.MethodsAnonymized data were collected from a questionnaire distributed to 159 patients with schizophrenia and their referring psychiatrists at three psychiatric hospitals between February 2014 and July 2014. The patients completed an original questionnaire developed to evaluate their attitudes regarding LAIs. Regarding the appropriateness of LAI prescription, patients and their referring psychiatrists were asked to rate, on a 5-point scale, how appropriate they felt the depot prescription was for the patients. The participants also answered instruments to assess symptom severity, antipsychotic-induced extrapyramidal symptoms, functions, quality of life, and self-esteem levels.ResultsPatients currently on LAIs have favorable attitudes toward LAIs with respect to side effects, relapse prevention, efficacy, pain, and cost. Expectation of relapse prevention was significantly associated with patients’ acceptance of LAIs (answering that those drugs are appropriate for their own treatment). In addition, the discrepancy between the patients’ and referring psychiatrists’ opinions regarding the appropriateness of LAI treatment was significantly associated with symptom severity, expectation of relapse prevention, belief that LAIs are painful, and belief that LAIs offer a reduced range of antipsychotic choices.ConclusionAttitudes toward LAIs need to be considered when deciding whether to prescribe this formulation. Access to information on LAIs, including their benefit in relapse prevention, might enhance the acceptance and use of this formulation among patients with schizophrenia.

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“…In current clinical practice, LAIs are often reserved for non-adherent patients, and psychiatrists themselves avoid prescribing LAIs to patients with first-episode schizophrenia [47]. While some patients prefer LAIs over OAPs due to increased relapse prevention [48] as well as better quality of life [49], others report being coerced into undergoing treatment with LAIs [50]; with pain at the injection site, misconceptions regarding LAIs, and lack of awareness also being reported as reasons for low LAI uptake [51,52]. Bridges et al [53] recently quantified the effect of schizophrenia treatment goals on a patient's treatment plan.…”

Section: Discussionmentioning

confidence: 99%

Hospitalization Rates and Therapy Costs of German Schizophrenia Patients Who are Initiated on Long-Acting Injectable Medication: A Mirror-Image Study

et al. 2020

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Background Long-acting injectable (LAI) antipsychotics can reduce relapse, hospitalization, and costs in patients with schizophrenia. However, real-world evidence assessing the impact of treatment with LAIs in Germany is limited. Objective To provide updated evidence on the impact of LAI initiation on hospitalization rates and therapy costs. Methods Using a mirror-image design, claims data of 850 German patients with schizophrenia who initiated treatment with LAIs during 2013-2015 was retrospectively analyzed. For the included patients, costs and resource utilization were compared for the 12 months before the index date (first initiation of LAI) and the 12 months after the index date. Annual treatment costs, hospitalization rates, ambulatory visits, sick leaves and medical aids were assessed. Two models were used to evaluate hospitalization and its costs. In model 1, hospitalization during the index date (first LAI prescription in 2013-2015) was allocated to the "pre-" time interval, while in model 2 it was neither attributed to the pre-nor to the post-index date. Regression analysis was performed to identify patients who benefited the most in terms of cost reduction from LAI initiation. Results Medication costs were significantly higher post-switching to LAI compared with pre-switching period (€3832 vs €799; p < 0.001). In model 1, number of hospitalizations, days hospitalized, and associated costs were significantly lower post-switching compared with pre-switching (2.3 vs 2.6; 59.2 vs 73.4; and €5355 vs €11,908, respectively; all p < 0.001). Similar results were obtained for costs in model 2 (€5355 vs €10,276; p < 0.001). Mean total costs reduced significantly from pre-switching to post-switching period in model 1 (€13,776 vs €10,418; p < 0.001). Patients with characteristics such as higher number of non-psychiatric and psychiatric inpatient stays during the pre-index period (all p < 0.05) benefited the most from cost reduction after LAI initiation. Conclusion In this cohort of German patients with schizophrenia, treatment initiation with LAI resulted in reduced hospitalization rates and total costs.

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Changes in attitude towards LAI antipsychotic maintenance treatment: A two-year follow-up study

Cited by 17 publications

References 47 publications

Patients’ perspectives on three-monthly administration of antipsychotic treatment with paliperidone palmitate – a qualitative interview study

Patients’ perspectives on three-monthly administration of antipsychotic treatment with paliperidone palmitate – a qualitative interview study

Attitudes toward long-acting injectable antipsychotics among patients with schizophrenia in Japan

Hospitalization Rates and Therapy Costs of German Schizophrenia Patients Who are Initiated on Long-Acting Injectable Medication: A Mirror-Image Study

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