1151 – Clinicians’ attitudes toward the use of long-acting injectable antipsychotics

Abstract

In schizophrenia, depot formulations are not widely used in everyday practice. Clinicians’ attitudes play a major role in this low level of use of Long Acting Injectable (LAI). As a consequence, only 35% of patients declare to be well- informed about those formulations. This study aims to assess psychiatrists’ attitudes toward the use of long-acting injectable antipsychotics in schizophrenia. During the French Congress of Psychiatry (November 2010, Lyon), we interviewed 113 psychiatrists about the factors that influenced their prescription of LAI. We used a structured interview, adapted from the two questionnaires developed by Heres et al. in two studies about the attitudes of German Psychiatrists. Multidimensional and cluster analyses were performed to identify correlations. Hazard risk for others, depot experienced, non-compliance and relapse in the past incited psychiatrists to prescribe LAI antipsychotic. Two different clusters of patients were identified: cluster I corresponded to patients with a past history of relapse and poor compliance and cluster II corresponded to patients with a high level of insight and of therapeutic alliance. The most important factor against the use of LAI was a sufficient estimated compliance with the oral formulation. The risk of extrapyramidal symptoms is, in our sample, one of the main reasons for a limited use of depot neuroleptic. Most factors influencing clinicians’ attitudes toward the use of LAI are shared in many countries. Some attitudes related to organisational aspects, particularly the relevance of healthcare costs may vary from one country to another.