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. 2020 Dec 22:10:2045125320978102.
doi: 10.1177/2045125320978102. eCollection 2020.

Reasons for initiating long-acting antipsychotics in psychiatric practice: findings from the STAR Network Depot Study

Corrado Barbui  1 , Federico Bertolini  1 , Francesco Bartoli  2 , Carmela Calandra  3 , Camilla Callegari  4 , Giuseppe Carrà  2 , Armando D'Agostino  5 , Claudio Lucii  6 , Giovanni Martinotti  7 , Daniele Mastromo  8 , Daniele Moretti  9 , Emiliano Monzani  10 , Matteo Porcellana  8 , Davide Prestia  11 , Giovanni Ostuzzi  12 ; STAR Network Investigators
Affiliations

Reasons for initiating long-acting antipsychotics in psychiatric practice: findings from the STAR Network Depot Study

Corrado Barbui et al. Ther Adv Psychopharmacol. .

Abstract

Background: Long acting injectable (LAI) antipsychotics have been claimed to ensure treatment adherence and possibly reduce the daily burden of oral formulations. So far, only surveys investigating the theoretical prescribing attitudes of clinicians have been employed. On this basis, we aimed to investigate reasons for prescribing LAIs in a real-world, unselected sample of patients.

Methods: The STAR Network Depot Study is an observational, multicentre study consecutively enrolling adults initiating a LAI over a 12-months period. Clinical severity was assessed with the Brief Psychiatric Rating Scale, and patient's attitude toward medications with the Drug Attitude Inventory 10 items. Psychiatrists recorded reasons for LAI prescribing for each study participant. Responses were grouped into six non-mutually exclusive categories: aggressiveness, patient engagement, ease of drug taking, side-effects, stigma, adherence.

Results: Of the 451 patients included, two-thirds suffered from chronic psychoses. Improving patient engagement with the outpatient psychiatric service was the most common reason for prescribing LAIs (almost 80% of participants), followed by increasing treatment adherence (57%), decreasing aggressiveness (54%), and improving ease of drug taking (52%). After adjusting for confounders, logistic regression analyses showed that reasons for LAI use were associated with LAI choice (e.g. first-generation LAIs for reducing aggressiveness).

Conclusion: Despite the wide availability of novel LAI formulation and the emphasis on their wider use, our data suggest that the main reasons for LAI use have remained substantially unchanged over the years, focusing mostly on improving patient's engagement. Further, clinicians follow implicit prescribing patterns when choosing LAIs, and this may generate hypotheses for future experimental studies.

Keywords: antipsychotic; long-acting injectable; prescribing attitudes; psychiatric practice; survey.

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Conflict of interest statement

Conflict of interest statement: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Reasons for long acting injectable antipsychotic use in 451 patients initiating treatment with long-acting antipsychotics.
See this image and copyright information in PMC

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