The knowledge and attitudes of psychiatrists towards antipsychotic long-acting injections in Nigeria

Abstract

Abstract:Background: Antipsychotic long-acting injections (LAIs) reduce covert nonadherence with medication in the clinical management of psychotic disorders. However, they are variably utilised by clinicians, especially in the long term. Factors including poor knowledge, stigma and perceived coercion can all adversely influence LAI utilisation. Previous research has emanated almost exclusively from developed countries. This study explores the knowledge and attitudes of psychiatrists and trainees in Nigeria towards LAIs. Methods: A cross-sectional study was undertaken among mental health professionals in Nigeria using a pre-existing questionnaire. Results: Participant psychiatrists (n = 128) expressed positive attitudes towards LAIs. Their knowledge concerning LAIs and its side effects was fair. The participants reported that nearly half (41.7%) of their patients with a psychotic illness were on LAIs. Those who reported a high prescribing rate for LAIs (>40%) were more likely to endorse more positive 'patient-centred attitudes' (p < 0.04). In contrast to previous reports, psychiatrists reported that patients were less likely to feel ashamed when on LAIs, though most endorsed the statement that force was required during LAI administration. Conclusion: The desirability of treatment by injections differs in Africa in comparison to Western cultures, possibly due to the increased potency that injections are perceived to have. This is perhaps evidenced by high rates reported for use of LAIs. Nigerian psychiatrists had positive attitudes to LAIs but their knowledge, particularly regarding side effects, was fair and needs to be improved. Providing information to patients prior to antipsychotic treatment may enhance informed consent in a country where medical paternalism is still relatively strong.

Reliability and validity of the Medication Adherence Rating Scale in a cohort of patients with schizophrenia from Nigeria

“…First, it would have been ideal to compare subjective rating of adherence with health worker-rated perception of adherence; however, we utilized an "indirect" measure of adherence which was to identify participants on depot preparations, who receive such preparations primarily due to poor or non-adherence. 26 Second, while this study overcomes a limitation identified by Fialko et al 25 in using an outpatient population exclusively, it may not be entirely …”

Attitude and preferences towards oral and long-acting injectable antipsychotics in patients with psychosis in KwaZulu-Natal, South Africa

“…The only study on attitude towards LAI antipsychotics in Nigeria was based on clinician attitude towards depot antipsychotics. 19 This current study, therefore sought to understand patients’ drug attitude and preference of oral compared to LAI antipsychotic medications.…”

Perceptions and knowledge of antipsychotics among mental health professionals and patients

“…According to previous studies, physicians' knowledge regarding antipsychotic formulations varies. 16 , 17 Physicians in the current study showed very good knowledge. However, a significant proportion of the interviewed nurses had knowledge gaps concerning some of the advantages of LAIs.…”

“… 12 Some physicians claimed that they offered LAIs early in the disease course, but their most common reasons for prescribing LAIs were poor adherence to oral medication and recurring relapses. Previous studies also report non-adherence 16 , 17 and multiple relapses 17 as key criteria for prescribing LAIs. This may be unfortunate as longer illness duration was associated with being reluctant to switch.…”