Transitioning Patients to Long-Acting Injectable Antipsychotics: Attitudes and Perceptions of US Clinicians Based on a Hypothetical Case (Results From the DECIDE Survey)

This work was sponsored by Teva Branded Pharmaceutical Products R&D, Inc. Background: Treatment with long-acting injectable antipsychotics (LAIs) reduces relapses in schizophrenia; however, best practices for introducing and transitioning patients to LAIs, as well as how to navigate barriers to LAI initiation, vary among clinicians. Methods: Using an online survey (DECIDE), the attitudes and perceptions of US clinicians toward the use of LAIs for schizophrenia were solicited using a hypothetical case. Results: Of 380 respondents, 295 were psychiatrists and 85 were psychiatric nurse practitioners/physician associates. In the survey, clinicians were provided hypothetical dialogue between a psychiatrist and a 38-year-old woman with schizophrenia, nonadherent to her oral antipsychotic therapy. The psychiatrist attempts to discuss making a transition to an LAI but is unsuccessful in changing the patient’s medications at the appointment. When presented with this dialogue, 60% of respondents felt that the clinician in the case did not provide enough information on the benefits of LAIs, 29% felt that the clinician seemed hesitant/reluctant to bring up LAIs, and 15% felt that the clinician gave up too early. When respondents were grouped by their general attitudes and preferences toward LAI use, those who were early LAI users were more likely to feel that the clinician in the case gave up too early compared with clinicians who were LAI hesitant (18% vs 9%; P>.05). Conclusions: These results highlight the importance of continuing clinician education on techniques to use in conversations with patients when introducing LAIs and the importance of keeping the conversation going.