Barriers to LAI Use Span Prescriber, Patient, Administrative Realms

Despite evidence showing the effectiveness of long-acting injectable antipsychotic medications (LAIs) for the maintenance treatment of patients with bipolar disorder and schizophrenia, some patients and physicians remain reluctant to use them.

A poster presented at the virtual 2021 American Psychiatric Association Annual Meeting identified specific physician, patient, and administrative factors hindering LAI use.

“Since the LAIs have shown favorable outcomes in recent studies to prevent relapse of their primary psychiatric conditions, it is crucial to identify and address the factors limiting use,” wrote first author Kaushal Shah, MD, MH, and colleagues at Griffin Memorial Hospital, Norman, Oklahoma.

Researchers came to their findings through a systematic review of articles addressing LAI barriers that were published between January 1, 2003, and July 31, 2020, and identified using the Medline, PubMed, and PubMed Central databases.

According to the poster, physician factors curbing LAI use in patients include inadequate expertise to manage patients, lack of knowledge and awareness, and poor attitudes and beliefs toward LAIs.

For patients, barriers to LAI use include inaccurate perceptions, inadequate knowledge, fear, a preference for oral medications, cost, convenience, and stigma toward LAIs.

Administrative barriers include insufficient staffing and insurance policies.

“Appropriate policies, prescribing guidelines, provider’s training, developing good patient-doctor treatment relationships, and creating public health awareness could help overcome these barriers of LAI use and improve mental health outcomes,” researchers advised in the poster.

—Jolynn Tumolo

Reference

Shah K, Mekala H, Morris C. Limiting factors and barriers for using long-acting injectable antipsychotic medications in psychiatric care. Poster presented at the American Psychiatric Association Annual Meeting; May 1-3, 2021; Virtual.