David M Taylor1,2, Sitaram Velaga3, Ursula Werneke4. 1. a Pharmacy Department Denmark Hill , Maudsley Hospital , London , UK. 2. b King's College London Institute of Pharmaceutical Science , London , UK. 3. c Department of Health Sciences , Lulea University of Technology , Lulea , Sweden. 4. d Department of Clinical Sciences, Division of Psychiatry, Sunderby Research Unit , Umeå University , Umeå , Sweden.
Abstract
BACKGROUND: Long acting injectable antipsychotics (LAI-APs) are considered a major advance in psychiatric treatment concerning treatment adherence and outcomes. Yet, both, doctors and patients remain sceptical. AIM: To explain the rationale for using LAI-APs, review their effectiveness and explore barriers to use. METHOD: Clinical overview of LAI-APs from the patient and doctor's perspective. RESULTS: LAI-APs were developed to increase adherence to treatment, thereby improving treatment outcomes. LAI-APs may reduce the risk of relapse and hospitalisation. Yet, the evidence from the few meta-analyses available remains weak. Both patients and doctors may associate LAI-APs with stigma and coercion. Current means of improving adherence include more focus on the therapeutic relationship, better information, adverse effects minimisation and half-life extension of LAI-APs. Future means of improving adherence include novel administration techniques that abolish the need for injection. CONCLUSIONS: For both, clinicians and drug developers, drug adherence remains a major target for improving treatment outcomes.
BACKGROUND: Long acting injectable antipsychotics (LAI-APs) are considered a major advance in psychiatric treatment concerning treatment adherence and outcomes. Yet, both, doctors and patients remain sceptical. AIM: To explain the rationale for using LAI-APs, review their effectiveness and explore barriers to use. METHOD: Clinical overview of LAI-APs from the patient and doctor's perspective. RESULTS:LAI-APs were developed to increase adherence to treatment, thereby improving treatment outcomes. LAI-APs may reduce the risk of relapse and hospitalisation. Yet, the evidence from the few meta-analyses available remains weak. Both patients and doctors may associate LAI-APs with stigma and coercion. Current means of improving adherence include more focus on the therapeutic relationship, better information, adverse effects minimisation and half-life extension of LAI-APs. Future means of improving adherence include novel administration techniques that abolish the need for injection. CONCLUSIONS: For both, clinicians and drug developers, drug adherence remains a major target for improving treatment outcomes.
Authors: Gabriel G Edwards; Ayako Miyashita-Ochoa; Enrico G Castillo; David Goodman-Meza; Ippolytos Kalofonos; Raphael J Landovitz; Arleen A Leibowitz; Craig Pulsipher; Ed El Sayed; Steven Shoptaw; Chelsea L Shover; Michelle Tabajonda; Yvonne S Yang; Nina T Harawa Journal: AIDS Behav Date: 2022-09-05