Impact of COVID-19 Pandemic on Prescribing of Long-Acting Injectable Antipsychotics for Schizophrenia: Results from a United States Prescriber Survey

Abstract

Purpose To describe changes due to the COVID-19 pandemic in the prescribing of long-acting antipsychotics (LAI) for schizophrenia, patient outcomes, and patient and healthcare provider (HCP) attitudes regarding COVID-19 vaccination in the United States (US). Methods An anonymous online survey was administered to US-based LAI prescribers with a psychiatry specialty in May 2021. Information on prescriber and clinical practice characteristics, LAI prescribing, patient outcomes, and attitudes toward COVID-19 vaccination was collected and described. Results Of the 401 LAI prescribers meeting survey criteria, 64.6% reported that LAI prescribing remained unchanged (increase: 19.2%, decrease: 14.0%). The majority did not switch patients from LAIs to oral antipsychotics (OAP; 63.3%) or to LAI formulations with lower frequency of administration (68.1%); most prescribers switched the same number of patients from OAPs to LAIs during the pandemic as in previous practice (65.1%). Half of LAI prescribers (50.1%) reported antipsychotic adherence as unchanged among most patients; 44.6% reported symptom control/relapse frequency as unchanged. Most prescribers believed their patients with schizophrenia should be prioritized for COVID-19 vaccination (74.1%) and encouraged all patients to obtain a COVID-19 vaccine (84.0%). However, 64.1% of prescribers reported hesitancy among some patients about vaccines’ safety; 51.4% reported that some patients were willing to be vaccinated despite the hesitancy, 48.6% indicated that some patients perceived COVID-19 vaccines as safe, effective, and important. Conclusion LAI prescribing and prescriber-reported antipsychotic adherence in patients with schizophrenia remained largely unchanged approximately one year after the start of COVID-19. Focused efforts to overcome patients’ COVID-19 vaccine hesitancy are warranted.

Long-acting Injectable Antipsychotics during the COVID-19 pandemic in schizophrenia: An observational study in a real-world clinical setting

“…However, this result is in line with the recommendations issued by the American Psychiatric Association, which suggested to avoid discontinuation of LAI treatment, particularly in patients in chronic phases of the illness despite the difficulties presented by the pandemic ( Keepers et al., 2020 ), and with the results of other recent studies conducted in the USA ( Gannon et al., 2020 ; Zhdanava et al., 2022 ).…”

“…A recent healthcare provider-based survey reported that the administration and the prescriber-reported adherence to LAI antipsychotics remained substantially stable during the pandemic period in the USA ( Zhdanava et al., 2022 ).…”

Use of Long-Acting Injectable Antipsychotics in a Clinical Sample of Community-Dwelling Patients with Schizophrenia-Spectrum Disorders in Rural Greece

“…Some studies have suggested that there may be a reduction in LAI initiation. A recent study in Romania found a 48.3% reduction in new LAI prescriptions compared to the pre-pandemic period [ 57 ], whereas in the US, LAI prescribing remained unchanged in 64.6% of cases, according to a survey among 401 LAI prescribers [ 58 ]. However, other research yielded different results.…”

Impact of the COVID-19 Pandemic on Medication Adherence and Maintenance Treatment for Schizophrenia: A Reconsideration [Letter]

“…I read with interest Zhdanava et al’s article titled: “Impact of COVID-19 pandemic on prescribing of long-acting injectable antipsychotics for schizophrenia: Results from a United States prescriber survey”, 1 in which the authors stated that, of 401 long-acting injectable (LAI) prescribers in their study, 64.6% reported no change to their LAI prescriptions during the COVID-19 pandemic. Moreover, 50% of LAI prescribers reported no change in adherence rates to oral antipsychotic medications.…”

“… 3 The present study and that of Ifteni et al also raised concerns regarding online medical care. 1 , 4 In terms of LAI treatment, Ifteni et al showed that extending the frequency of administration as much as possible during the COVID-19 pandemic was desirable. 4 Our study also showed higher expectations for longer formulation of atypical antipsychotics.…”