Medication Preference for Injectable Versus Oral Antipsychotics in Patients With Schizophrenia: Results From a Patient-Reported Questionnaire From a Double-Blind Randomized Controlled Study

Introduction: Assessing factors that determine patients’ preferences for long-acting injectable (LAI) or oral antipsychotics could help reduce potential barriers to LAI use in schizophrenia.

Methods: Post-hoc analyses were conducted from a double-blind, randomized, non-inferiority study (NCT01515423) of 3-monthly vs 1-monthly paliperidone palmitate in patients with schizophrenia. Data from the Medication Preference Questionnaire, administered to patients on day 1 (baseline; open-label stabilization phase), were used. The questionnaire includes 4 sets of items: (1) reasons for general treatment preference based on goals/outcomes and preference for LAI vs pills based on (2) personal experience (3) injection-site (4) dosing frequency.

Results: Patients who preferred LAIs identified these outcomes as important: “I feel more healthy” (57%), “I can get back to my favorite activities” (56%), “I don’t have to think about taking my medicines” (54%). Most common reasons for medication preference (LAI vs pills) were: “LAIs/pills are easier for me” (67% vs 18%), “more in control/don’t have to think about taking medicine” (64% vs 14%), “less pain/sudden symptoms” (38% vs 18%) and “less embarrassed” (0% vs 46%). Majority of patients (59%) preferred deltoid over gluteal injections: (reasons: faster administration [63%], easier [51%], less embarrassing [44%]). 50% of patients preferred 3-monthly over 1-monthly (38%) or every day (3%) dosing (reasons: fewer injections [96%], fewer injections are less painful [84%], fewer doctor visits [80%])

Conclusion: Patient empowerment and quality-of-life-related goals were important for patients who preferred LAI antipsychotics and when given an option, patients preferred less-frequent, quarterly injections over monthly injections and daily oral medications.

This poster was presented at the 32nd annual Psych Congress, held Oct. 3-6, 2019, in San Diego, California.