Table 4.
First- and high second-line expert ratings on the importance of potential facilitators for consideration of LAI use in a patient with schizophrenia/schizoaffective or bipolar disorder
| Rating | Factors, beliefs, or perceptions about LAIs by healthcare providers that would facilitate consideration of an LAI (mean [SD] ratinga) |
|---|---|
| First line | Reduced risk of relapse and hospitalization (8.3 [1.0]) |
| Improved patient outcomes (8.2 [1.1]) | |
| No need for patient to make a daily decision to take medication or remember to take medication daily (8.1 [0.9]) | |
| Reduced symptoms because of continuous medication coverage (7.8 [1.6]) | |
| Reduced burden and increased satisfaction for families (7.6 [1.3]) | |
| Ability for the clinician to identify nonadherence immediately and intervene as soon as it is detected (7.6 [1.7]) | |
| Better symptom control for patient who might abuse substances and reduce or stop medication (7.6 [1.4]) | |
| Improved patient and physician satisfaction (7.4 [1.3]) | |
| No or minimal concern about LAI being taken incorrectly or misused because staff are administering (reduced risk of unintentional or deliberate overdose) (7.2 [1.3]) | |
| High second lineb | Ability for the clinician to discriminate inadequate response due to lack of efficacy versus poor response due to adherence problems (7.1 [2.0]) |
| No need for patient to refill prescription for oral medication (6.9 [2.1]) | |
| No concern about patient losing medication (6.9 [1.7]) | |
| Ensures regular contact between patient and treatment team (6.7 [2.0]) | |
| More time to focus on nonmedication-related issues rather than adherence issues in clinical sessions (6.7 [1.9]) | |
| Reduced stigma associated with having to take daily psychiatric medication (6.7 [1.8]) | |
| Patients who travel do not need to carry medication with them (6.4 [2.0]) | |
| Less variation in peak-to-trough antipsychotic blood level with lower risk of peak-level side effects (6.3 [1.8]) |
Notes:
a
Rating scale: 1 = not important at all, 2–3 = not very important, 4–6 = somewhat important, 7–8 = important, 9 = extremely important; bold indicates an option rated 9 by ≥50% of the experts.
b
High second-line options are those for which the upper value of the CI is ≥6.5, the boundary for first line.
Abbreviation: LAI, long-acting injectable antipsychotic.