SHBC1666

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.