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Review
. 2024 Oct 19:20:1995-2010.
doi: 10.2147/NDT.S477674. eCollection 2024.

Introducing S.C.O.P.E.™ (Schizophrenia Clinical Outcome Scenarios and Patient-Provider Engagement), an Interactive Digital Platform to Educate Healthcare Professionals on Schizophrenia Care

Christoph U Correll #  1   2   3   4 , Jose M Rubio #  1   2   3 , Leslie Citrome #  5 , Marko A Mychaskiw  6 , Stephen Thompson  6 , Kelli R Franzenburg  7 , Mark Suett  8 , Sameer Kotak  9 , John M Kane #  1   2   3
Affiliations
Review

Introducing S.C.O.P.E.™ (Schizophrenia Clinical Outcome Scenarios and Patient-Provider Engagement), an Interactive Digital Platform to Educate Healthcare Professionals on Schizophrenia Care

Christoph U Correll et al. Neuropsychiatr Dis Treat. .

Abstract

Despite evidence of benefits beyond those of oral antipsychotics, long-acting injectable antipsychotics (LAIs) are underused in schizophrenia treatment. Underuse may be partially a result of misconceptions held by some healthcare professionals (HCPs) pertaining to LAIs. A panel of four experts convened between January 2022 and May 2022 to identify these misconceptions, and example cases or scenarios were created to illustrate common clinical situations relevant to these beliefs. Ultimately, an online platform and heuristic tool, Schizophrenia Clinical Outcome Scenarios and Patient-Provider Engagement (S.C.O.P.E.™), was developed to help prescribing clinicians and other HCPs better understand common clinical dilemmas, as well as the place for LAIs in schizophrenia treatment. Three main misconceptions related to the use of LAIs to treat schizophrenia were identified and included "physicians/providers know when patients are nonadherent", "patients do not accept/want LAI treatment", and "LAIs are only appropriate for patients who have demonstrated nonadherence". All misconceptions are refuted by current evidence and were used to develop clinical scenarios with questions to consider when patients present to various sites of care for treatment. These cases are presented on the S.C.O.P.E. educational platform. The platform also includes videos designed to help non-prescribing HCPs and mental health professionals address patient/caregiver concerns and to communicate LAI benefits. In addition, S.C.O.P.E. provides a section with information about each LAI that is currently FDA approved in the United States for the treatment of schizophrenia, to help familiarize HCPs with characteristics of LAIs. S.C.O.P.E. is an educational tool designed for HCPs to help improve their understanding of how to manage common clinical dilemmas in the treatment of people with schizophrenia, to clarify the role of LAIs in medication management, and to increase understanding of the characteristics of available LAIs. S.C.O.P.E. also aims to improve care in schizophrenia by facilitating increased awareness to patients and caregivers.

Keywords: education; long-acting injectable antipsychotic; patient outcomes; schizophrenia; treatment.

Plain language summary

Schizophrenia is a serious, lifelong mental health disorder that affects about 2.8 million adults in the United States and many more worldwide. Symptoms can include hallucinations (ie, hearing “voices”), delusions (ie, convinced something is true when it is not), poor attention, lack of motivation and interest, and cognitive problems. Schizophrenia can have considerable impact on people with the disorder as well as their families, friends, and communities. There are several treatment options available for healthcare professionals (HCPs), patients, and caregivers to consider, with antipsychotic medicines being the cornerstone of the treatment for schizophrenia. Long-acting injectable antipsychotics (LAIs) have shown benefits over antipsychotics taken orally (by mouth), but are underused, and this is likely due to some common misconceptions. Four experts in schizophrenia treatment met repeatedly online to identify some of these misconceptions and created a tool to help HCPs learn about misconceptions, using example cases of patients with schizophrenia who have different types of clinical situations and concerns. On the Schizophrenia Clinical Outcome Scenarios and Patient-Provider Engagement (S.C.O.P.E.™) interactive digital platform, HCPs can choose in which type of case they are interested in and see details of the case, information they should obtain about the case, and appropriate considerations for LAI use. The tool also provides videos about communicating with patients and their families about LAIs, and information about the different LAIs currently available. The goal of providing this tool to HCPs is to improve understanding of how to treat patients with schizophrenia and the role that LAIs can play.

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Conflict of interest statement

CUC has been a consultant for or has received honoraria from AbbVie, Acadia Pharmaceuticals, Adock Ingram, Alkermes, Allergan, Angelini Pharma, Aristo Pharma, Biogen, Boehringer Ingelheim, Cardio Diagnostics, Cerevel Therapeutics, CNX Therapeutics, COMPASS Pathways, Darnitsa, Denovo Biopharma, Gedeon Richter, Hikma, Holmusk, Intra-Cellular Therapies, Janssen, Johnson & Johnson, Karuna Therapeutics, LB Pharmaceuticals, Laboratorios Farmacéuticos ROVI, Lundbeck, MedAvante-ProPhase, MedinCell, Merck, Mindpax, Mitsubishi Tanabe Pharma, Maplight, Mylan, Neumora Therapeutics, Neurocrine Biosciences, Neurelis, Newron Pharmaceuticals, Noven, Novo Nordisk, Otsuka, Pharmabrain, PPD Biotech, Recordati, Relmada, Reviva, Sunovion, Supernus Pharmaceuticals, Takeda, Teva Pharmaceuticals, and Viatris; has provided expert testimony for Janssen and Otsuka and served on data safety monitoring boards or advisory boards for COMPASS Pathways, Denovo Biopharma, Laboratorios Farmacéuticos ROVI, Lundbeck, Relmada, Reviva, Sage Therapeutics, Supernus Pharmaceuticals, Tolmar, and Teva Pharmaceuticals; has received grant support from Janssen and Takeda and received royalties from UpToDate; serves on the board of directors for the American Society of Clinical Psychopharmacology; and is a stock option shareholder of Cardio Diagnostics, Mindpax, LB Pharmaceuticals, PsiloSterics, and Quantic Group. JMR has been a consultant for and has received support for attending meetings/travel from Teva Pharmaceuticals; has received honoraria from Lundbeck; has received grants from Alkermes, Janssen, Karuna, and the National Institute of Mental Health (NIMH); has received royalties/licensing fees from UpToDate; and owns stock/stock options in Doximity. LC is a consultant for AbbVie/Allergan, Acadia, Adamas, Alkermes, Angelini, Astellas, Avanir, Axsome, BioXcel, Boehringer Ingelheim, Cadent Therapeutics, Cerevel, Clinilabs, COMPASS, Delpor, Eisai, Enteris BioPharma, HLS Therapeutics, Idorsia, INmune Bio, Impel, Intra-Cellular Therapies, Janssen, Karuna, Lundbeck, Lyndra, Medavante-ProPhase, Marvin, Merck, Mitsubishi-Tanabe Pharma, Neurocrine, Neurelis, Noema, Novartis, Noven, Otsuka, Ovid, Praxis, Recordati, Relmada, Reviva, Sage, Sunovion, Supernus, Teva, and University of Arizona, Vanda, Wells Fargo, and provides one-off ad hoc consulting for individuals/entities conducting marketing, commercial, or scientifi c scoping research; is a speaker for AbbVie/Allergan, Acadia, Alkermes, Angelini, Axsome, BioXcel, Eisai, Idorsia, Intra-Cellular Therapies, Janssen, Lundbeck, Neurocrine, Noven, Otsuka, Recordati, Sage, Sunovion, Takeda, Teva, and CME activities organized by medical education companies, such as Medscape, NACCME, NEI, Vindico, and universities and professional organizations/societies; holds stocks (small number of shares of common stock) in Bristol-Myers Squibb, Eli Lilly, Johnson & Johnson, Merck, and Pfizer, purchased over 10 years ago, with stock options in Reviva; receives royalties/publishing income from Taylor & Francis (Editor-in-Chief, Current Medical Research and Opinion, 2022–present), Wiley (Editor-in-Chief, International Journal of Clinical Practice, through the end of 2019), UpToDate (reviewer), Springer Healthcare (book), and Elsevier (Topic Editor, Psychiatry, Clinical Therapeutics). MAM, ST, KRF, and MS are employees or stockholders, or both, of Teva Pharmaceuticals. SK is an employee of Yorker Health, which has received payments from Teva Pharmaceuticals in relation to this study. JMK has been a consultant for or received honoraria from Alkermes, Boehringer Ingelheim, Cerevel, Click Therapeutics, Dainippon Sumitomo, HealthRhythms, HLS Therapeutics, Eli Lilly, EnVivo Pharmaceuticals (Forum), Forest (Allergan), Genentech, Indivior, Intra-Cellular Therapies, Janssen, Johnson & Johnson, Karuna Therapeutics, LB Pharmaceuticals, Lundbeck, Lyndra Therapeutics, Mapi, Maplight, Merck, Neurocrine Biosciences, Minerva, Neurocrine, Newron, Novartis, NW PharmaTech, Otsuka, Pierre Fabre, Reviva Pharmaceuticals, Roche, Saladax Biomedical, Sunovion, Takeda, Terran, and Teva Pharmaceuticals; has received grant support from Otsuka, Lundbeck, and Janssen; and is a shareholder of Cerevel, North Shore Therapeutics, LB Pharmaceuticals and Vanguard Research Group; has received royalties from UpToDate.

Figures

Figure 1
Figure 1
Clinical dilemmas on the S.C.O.P.E. platform.
Figure 2
Figure 2
Continued.
Figure 2
Figure 2
Continued.
Figure 2
Figure 2
Example emergency department S.C.O.P.E. scenario: acute episode following treatment discontinuation. (A) Scenario, (B) Assessments, (C) Considerations.
Figure 3
Figure 3
Example S.C.O.P.E. clinical education video - acute episode following oral treatment discontinuation, (A) patient and (B) case manager.
Figure 4
Figure 4
Selected LAIs and filter properties.
See this image and copyright information in PMC

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