Psychiatrists’ attitudes to antipsychotic depot injections (II): Changes over 5 years

Abstract

Background:Previously, when only typical antipsychotic depot injections were available, some clinicians perceived depots as having an “image” problem despite them being associated with reduced rates of rehospitalisation when compared to tablets. This study investigated psychiatrists’ attitudes and knowledge concerning depots (typical and atypical) and whether they had changed over time.Method:Cross-sectional postal survey of consultant psychiatrists working in NorthWest England. A pre-existing questionnaire on clinicians’ attitudes and knowledge regarding depots was updated. Results were compared with a former sample (SouthEast England, 2001: N=143).Results:The sample comprised 102 consultant psychiatrists (response rate 71%). Depot use over the past 5 years had: decreased (50%), not changed (27%), increased (23%). Psychiatrists with decreased depot use had significantly lower scores for the side effects knowledge subscale than those who had unchanged or increased rates of depot use (mean 51.5% vs 54.8%, p=0.029). When compared to psychiatrists sampled five years previously, our current participants had more favourable patient-focussed attitudes (63.5% vs 60.4%, p=0.034); other subscales did not differ. Item-by-item analysis revealed specific changes over time including significantly less respondents regarding depots as: (i) compromising patient autonomy (mean 0.99 vs 1.28, p=0.036); being stigmatising (1.88 vs 2.42, p=0.002); being old fashioned (1.49 vs 2.04, p=0.002).Conclusions:During the period that an atypical antipsychotic depot has been available, and depot prescribing rates have reduced, some attitudes have changed. These mainly encompass aspects regarding the patient rather than the depot injection and include reducing concerns about stigma and autonomy although concerns about patient acceptance continue.