Relapse rates are high among people with psychosis and in particular, schizophrenia. Some of the reasons for relapse include nonadherence to therapy and medication and inadequate support or medical care. Antipsychotic (AP) medication adherence is a crucial part of therapy and ongoing treatment for people with psychosis. However, many people forget to take their medication or simply choose not to due to negative side effects.
Relapse can occur in a matter of weeks after the discontinuation of AP medication. Therefore, it is important to identify other methods of ensuring and increasing medication adherence. One such approach is the use of long-acting injectable (LAI) APs. Although they are not widely used as of yet, their limited use has been shown to be highly effective. So why aren’t more clients with psychosis choosing to take LAI APs?
That was the question asked by Srividya Iyer, PhD, Assistant Professor of the Department of Psychiatry at McGill University in Montreal. Iyer recently conducted a study to explore why LAI APs are not more widely used in this segment of the population. Using a sample of 34 participants with schizophrenia, Iyer gathered information through focus groups pertaining to use and reservations regarding LAI use. The data revealed four major areas of concern: convenience of LAI use, costs, knowledge about LAI APs, and perceptions regarding their use.
Specifically, Iyer discovered that the majority of participants were not even aware of LAIs, and those that were had only partial information pertaining to them. The perceptions the participants held toward LAIs were quite positive, but only among those who were currently receiving them. This finding illuminates the need to strengthen awareness and education about LAI APs among this clinical population and their caregivers.
Cost was another issue that raised concern among the participants, as many times the shots are very expensive or not covered fully by insurance. Finally, when LAI APs were introduced under threat of legal intervention or with some measure of coercion, the participants were more resistant to the idea compared to when LAI APs were offered as one of many treatment options.
In sum, these findings provide valuable information regarding LAI AP use in a clinical sample. Iyer added, “These insights have implications for addressing the issue of underuse of LAIs, which, in turn, can help improve medication adherence in people with schizophrenia and other psychoses.”
Reference:
Iyer, Srividya, PhD, et al. (2013). A qualitative study of experiences with and perceptions regarding long-acting injectable antipsychotics: Part I–patient perspectives. Canadian Journal of Psychiatry 58.5 (2013): 9,14S,15S,16S,17S,18S,19S,20S,21S,22S. ProQuest. Web.
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