Why Isn’t Injectable Antipsychotic Medication Used More Frequently?

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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  • Letitia

    Letitia

    September 5th, 2013 at 3:39 AM

    Another one of those situations where something makes very good medical sense for the patient but due to be strong armed by the insurance companies the method isn’t being used like it could be.

  • vick

    vick

    September 6th, 2013 at 3:55 AM

    I work for a doctor and I can emphatically tell you that if most patients have a choice they are NOT going to choose and Injectable form of medicine. i hear it over and over again every day but people are afraid of getting a shot. And this is not just young people this is people of all ages. I have had to practically hold people down before and that’s no fun for anyone. So if the injectable is not more effective and no more cost efficient and they can’t give it to themselves seems there is no real benefit to anyone with that push.

  • Paulie

    Paulie

    September 9th, 2013 at 3:57 AM

    If this is simply all about giving patients another choice for managing their own health care, then why wouldn’t this be made more readily available to them? Especailly if the meds given this way are just as effective and the patient is willing to receive treatment in this manner? It just kind of sounds like there are a lot of things determing that this shouldn’t be used as much that have very little at all to do with what a patient actually wants and needs.

  • Disgusted

    Disgusted

    January 19th, 2014 at 1:06 PM

    These drugs should almost never be used. If you think they’re a good idea, I’d invite you to try living on them and see what a good solution they are for you. Oh, you say you aren’t the sick person? Who told you that? Maybe you need a few 2nd opinions.

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