Preferences for Selecting and Initiating Long-Acting Injectable Antipsychotics: A Survey of US Psychiatric Clinicians (Results from the DECIDE Survey)

This work was sponsored by Teva Branded Pharmaceutical Products R&D, Inc. Background: Although long-acting injectable antipsychotics (LAIs) improve adherence and reduce schizophrenia relapse rates, they remain underutilized in clinical practice. Methods: In DECIDE, psychiatric clinicians were surveyed regarding their preferences when selecting and initiating LAIs for schizophrenia. Clinicians were analyzed by LAI use (high [≥31% of their patients using LAIs] versus low [≤14% using LAIs]) and attitude toward LAI archetypes (early LAI use, severity reserved, adherence reserved, LAI hesitant). Results: Overall and across subgroups, respondents (n=380) ranked side effects/tolerability as the most important consideration when selecting a particular LAI for their patient, and “preference for the molecule” was ranked last. When compared by LAI utilization, product attributes was ranked the second most important characteristic by clinicians with high LAI use, whereas those with low LAI use ranked access/availability as second. When compared across archetypes, a greater proportion of clinicians who were LAI hesitant ranked patient preference as the second most important consideration. Across subgroups, multiple injection site options, small/on par needle, and price made at least two-thirds of clinicians somewhat/much more likely to use a particular LAI. In addition, 63%–82% of clinicians, regardless of subgroup, reported being somewhat/much more likely to select an LAI dosed once monthly or less often compared with 8% for an LAI dosed once every 2 weeks. Conclusions: Among psychiatric clinicians surveyed, the most important feature when selecting an LAI was the safety/tolerability profile, and the dosing frequency preferred most was once monthly or less often.