Understanding the Use of Long-Acting Injectable Antipsychotic Agents in Schizophrenia: A 2022 Survey of US Psychiatrists, Nurse Practitioners, and Physician Associates

Abstract: Background: Treatment with long-acting injectable antipsychotic agents (LAIs) has been shown to improve outcomes in schizophrenia; however, many healthcare providers continue to reserve LAIs for patients with severe disease or adherence issues. Methods: A survey regarding perspectives on schizophrenia management with oral antipsychotic agents (OAs) versus LAIs and related educational needs was distributed to US-based psychiatrists, psychiatric nurse practitioners (NPs), and physician associates (PAs). Results: Overall, 295 psychiatrists and 85 psychiatric NPs/PAs responded to the survey. Most (87%) agreed that treatment decisions in schizophrenia impact patient outcomes. 72% reported their perception of LAI use changed during their careers, mostly triggered by peer-reviewed publications (45%) and continuing medical education (41%). Overall, 68% and 37% of respondents agreed ‘LAIs are reserved for patients with adherence issues’ and ‘with more severe symptoms,’ respectively. Respondents believed that 53% of all patients are nonadherent with OAs yet considered only 26% of their patients taking OAs as nonadherent. In contrast, respondents reported 12% of their patients taking LAIs as nonadherent. Few respondents (1%) considered their utilization of LAIs as too high; 27% perceived it as too low. At least half of respondents reported being not at all/moderately confident in their knowledge of approved LAIs, determining when to begin an LAI, transitioning a patient to an LAI, and managing LAI side effects. Conclusions: These results highlight a need for education (eg, continuing medical education, peer-reviewed studies) to increase awareness of nonadherence and to instill confidence in initiating and utilizing LAIs in schizophrenia management.Short Description: Many psychiatric healthcare providers (HCPs) reserve long-acting injectable antipsychotic agents (LAIs) in schizophrenia for patients with severe disease or adherence issues, despite evidence that LAI use may lead to better patient outcomes. Results from this survey of psychiatric HCPs revealed several barriers to LAI use and areas for future educational interventions, including increasing awareness of nonadherence and relapse, improving attitudes towards LAI use, and increasing confidence in initiating therapy.Name of Sponsoring Organization(s): Teva Branded Pharmaceutical Products R&D, Inc.