Abstract
Long-acting injectable antipsychotics (LAIs) offer many benefits to patients with schizophrenia spectrum disorder (SSD). They are used with very different frequencies due to questions of eligibility or patients and prescribers’ attitudes towards LAI use. We assessed the prescribing rates of LAIs in a large academic psychiatric hospital with a public service mandate in Switzerland and compared them with other countries and health care systems. To our knowledge, this study is the first to investigate inpatient LAI use in Europe. Medical records of all patients diagnosed with SSD discharged from the Clinic of Adult Psychiatry of the University Hospital of Psychiatry Zurich over a 12 month period from January to December 2019 were evaluated regarding the prescribed antipsychotics at the time of discharge. The rates of use of LAIs among all patients and among patients receiving LAI-eligible antipsychotic substances were assessed retrospectively. We assessed records of 885 patients with SSD. Among all cases, 13.9% received an LAI. Among patients who received antipsychotic medication that was eligible for LAI use (n = 434), 28.1% received an agent as an LAI. LAI use included paliperidone palmitate (69.9%), aripiprazole monohydrate (14.6%), risperidone (4.9%) and first-generation LAIs (9.8%). Compared to international frequencies of LAI administration, the prescription rate of LAIs in SSD patients was low. Further studies will evaluate patient- and prescriber-related reasons for this low rate.
Highlights
Long-acting injectable antipsychotics (LAIs) emerged as an important and effective treatment option for patients with schizophrenia spectrum disorder (SSD), including schizophrenia, and are effective in reducing hospitalization [1]
Of the patients treated with an antipsychotic substance that is available as an LAI, 28.1% were treated with an LAI
The LAI prescribed most often was by far paliperidone palmitate, followed by aripiprazole monohydrate; risperidone microspheres and first-generation LAIs were prescribed in a small patient subgroup
Summary
Long-acting injectable antipsychotics (LAIs) emerged as an important and effective treatment option for patients with schizophrenia spectrum disorder (SSD), including schizophrenia, and are effective in reducing hospitalization [1]. In the US, among all patients receiving an antipsychotic agent eligible for LAI use, 4–28% receive their agent as an LAI [2–4]. LAIs were initially developed to improve adherence in patients suffering from SSD. Recent clinical studies suggest additional advantages [5]. The prescription of LAIs is associated with better adherence in a randomized controlled trial and a retrospective analysis [6,7]. A recent meta-analysis of prospective and retrospective cohort studies found that the risk for all-cause discontinuation was lower in patients receiving
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