L.Y.A.WONG1, J.H.LAU1, S.VERMA1, J.LEE1, C.TANG1, C.T.CHAN1, S.ZHENG1, A.K.GHOSH1, B.T.NG1
Institute of Mental Health1
Optimising the utilisation of antipsychotic LAIs could potentially achieve greater treatment consistency and relapse prevention in psychosis. This study examines the pattern of LAIs usage among outpatients with a diagnosis of schizophrenia at the Institute of Mental Health (IMH), and surveys the perceptions of IMH clinicians on offering LAIs.
A retrospective medication use evaluation was conducted on 400 randomly-selected outpatients with schizophrenia. A 23-item questionnaire was developed and conducted anonymously to explore IMH clinicians’ practice and perceptions on LAIs use.
Of the outpatients, 311 (77.8%) were on oral antipsychotics only, 34 (8.5%) were on LAIs only, and 55 (13.8%) were on both. For the group on both formulations, the median (IQR) of daily chlorpromazine dose equivalence for LAIs was 75mg (50mg, 100mg). Among 69 patients with admission records 1-year before and after LAI initiation, there was a significant reduction in both median (IQR) number of admissions [1 (0, 1) vs. 0 (0, 0.5), p<0.001) and length of stay in days [14 (0, 34.5) vs. 0 (0, 1.5), p<0.001] in the year preceding versus the year post-first initiation of LAIs. Among 54 clinicians who completed the questionnaire, most (87%) felt that LAIs are less acceptable by patients. Almost all would offer LAIs to patients who are non-adherent to oral antipsychotics and have experienced a relapse, but less often in offering LAIs to non-adherent patients who never relapsed.
LAIs reduced the frequency and duration of hospitalisations. Most clinicians offer LAIs to poorly-adherent patients with previous relapses.