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

Abstract

Data on the use of long-acting injectable antipsychotics (LAIs) in rural community mental healthcare settings are scarce. This study aimed to investigate the prescription patterns of LAIs in a clinical sample of patients with schizophrenia-spectrum disorders in rural Greece. All patients with schizophrenia-spectrum disorders who regularly attend the Mobile Mental Health Unit of the prefectures of Ioannina and Thesprotia (MMHU I-T) in northwestern Greece were included in the study. The sample consists of 87 patients (59 males and 28 females) with a mean age of 54.4 years and a mean illness duration of 28 years. Most patients (72.4%) received antipsychotic monotherapy, and nearly 30% received an LAI formulation, mostly a second-generation LAI (20 of 26 patients, 76.9%). The treatment regimen comprised benzodiazepines in one-third of the patients and antidepressants in one-quarter. There was no statistically significant association between treatment regimen and the clinical and demographic variables studied, except for biological sex (female). The percentage of patients treated with LAIs in this study was almost three times higher than the rate previously reported in Greece and is higher than the rates reported in other countries. Patients with schizophrenia-spectrum disorders in rural Greece may have adequate access to innovative treatment with second-generation LAIs. Further research is needed to demonstrate the cost-effectiveness of LAI treatment in rural communities and to elucidate the factors associated with such treatment.

Sociodemographic and clinical factors associated with prescription of first- versus second-generation long-acting antipsychotics in incarcerated adult males

“…Moreover, information for other variables were lacking, including mean monthly dosage for each LAI antipsychotic, reasons for prescribing LAI antipsychotics, previously administered antipsychotic medications (including the type of previous LAI antipsychotic), age at onset, duration of illness and the presence of other comorbid psychiatric diagnoses (Barbui et al, 2020;Pelizza et al, 2022;Auxilia et al, 2023). Nevertheless, other factors that may be associated with the type of prescribed LAI antipsychotic, including migration (Bani-Fatemi et al, 2019), living in rural or urban communities (Teplin, 1990;Peritogiannis et al, 2023) and comorbid neurodevelopmental disorders (such as autism spectrum disorder and attention deficit-hyperactivity disorder) (Iasevoli et al, 2020;Capuzzi et al, 2022) were not evaluated in this study for lack of reliable information. Fifth, most of the data is based on self-report, increasing the risk of recall bias and skewed self-presentation.…”

Mobile Mental Health Units in Greece: Bridging Clinical Practice and Research in the Rural Context

“…In general, research in the context of MMHUs is scarce and has been mostly conducted on islands [10][11][12] and on one site on the mainland [13][14][15][16]. Notably, most studies are single-center, which may limit the generalizability of their findings [17].…”