Prevention in Practice: Improving Communication on the Benefits of Treatments for Schizophrenia

Abstract: Antipsychotic treatment can help improve outcomes in schizophrenia by reducing the risk of relapse and psychiatric hospitalization, and increasing rates of remission and recovery, particularly when used early in the disease course. However, adherence to oral antipsychotics is often poor. Long-acting injectable (LAI) antipsychotic formulations are associated with significant improvements in treatment adherence compared with oral medications but, despite this, LAIs are not widely used in early-phase schizophrenia. The PRELAPSE study evaluated whether use of the LAI aripiprazole once-monthly 400 mg delayed the time to first hospitalization in early-phase schizophrenia, compared with usual care. In the study, clinicians received training on the rationale for LAI use in early psychosis, on transitioning to LAIs in different healthcare settings, and on discussing LAIs with patients and families. Communication training included the principles of shared decision-making, suggested responses to frequently asked questions, and role-playing. With the use of these techniques, 91% of eligible patients with early-phase schizophrenia were willing to use LAI treatment at least once in the first three months of the study. Offering clinicians training to improve their communication with patients, through techniques such as shared decision-making and motivational interviewing, may increase LAI use in early-phase schizophrenia. ‘Prevention in Practice’ is an educational training program offering clinicians a multitude of innovative, web-based, patient-centered resources, such as virtual role-play or educational films, which aim to improve communication between clinicians and patients and help progress care for patients with early-phase schizophrenia.Short Description: Long-acting injectable (LAI) formulations of antipsychotics are associated with significant improvements in treatment outcomes versus oral medications, but they are not widely used in early-phase schizophrenia. Results of the PRELAPSE study suggest that providing clinicians with training on LAIs and communication techniques may increase LAI use in early-phase schizophrenia. ‘Prevention in Practice’ is an educational program offering healthcare professionals training resources to improve communication with patients and help progress care for patients with early-phase schizophrenia.Name of Sponsoring Organization(s): Otsuka Pharmaceutical Development & Commercialization Inc., Princeton, NJ, USA H. Lundbeck A/S, Valby, Denmark