BMC Psychiatry | |
Attitudes towards the administration of long-acting antipsychotics: a survey of physicians and nurses | |
Andreas Schreiner2  Guadalupe Martinez3  Paul Geerts1  | |
[1] Janssen, Antwerpseweg 15-17, Beerse, 2340, Belgium;Janssen, Johnson & Johnson Platz 5a, Neuss, D-41470, Germany;Janssen, Paseo de las doce estrellas 5-7, Madrid, 28042, Spain | |
关键词: Gluteal; Deltoid; Long-acting injectable; Attitude; Antipsychotic; | |
Others : 1124135 DOI : 10.1186/1471-244X-13-58 |
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received in 2012-01-17, accepted in 2013-02-04, 发布年份 2013 | |
【 摘 要 】
Background
Discontinuation of antipsychotic treatment for schizophrenia can interrupt improvement and exacerbate the illness. Reasons for discontinuing treatment are multifactorial and include adherence, efficacy and tolerability issues. Poor adherence may be addressed through non-pharmacological approaches as well as through pharmacological ones, ie ensured delivery of medication, such as that achieved with long-acting injectable (LAI) antipsychotics. However, attitudes of healthcare professionals (HCPs) towards LAI antipsychotics may influence their prescribing decisions and may influence medication choices offered to patients. We therefore conducted a survey to investigate factors driving LAI use as well as physician and nurse attitudes to LAI antipsychotics and to different injection sites.
Methods
An independent market research agency conducted the survey of HCPs across Europe. Participants were recruited by telephone and completed the survey online. Using conjoint analyses (a multivariate statistical technique analysing preferences on the basis of ranking a limited number of attributes which are presented repetitively), attitudes to oral versus LAI medication and gluteal versus deltoid injection routes were assessed.
Results
A total of 891 HCPs across Europe were surveyed. Of these, 40% would choose LAI antipsychotics for first episode patients whereas 90% would select LAI antipsychotics for chronic patients with two to five psychotic episodes. Dominant elements in antipsychotic choice were low sedation but no tardive dyskinesia, no or mild pain at injection and low risk of embarrassment or impact upon therapeutic alliance. Eighty-six per cent of respondents considered that having the choice of a deltoid as well as gluteal administration site was beneficial over not having that choice. Two thirds of respondents said they agreed that medication administration via the deltoid muscle may reduce social embarrassment associated with LAI antipsychotics and most respondents (61%) believed that administration of LAI antipsychotics into the deltoid muscle as opposed to the gluteal muscle may be more respectful to the patient.
Conclusions
In this survey of physicians and nurses, attitudes towards LAI antipsychotics compared with oral medication were generally positive. Respondents considered that the availability of a deltoid administration route would offer increased choice in LAI antipsychotic administration and may be perceived as more respectful and less socially embarrassing.
【 授权许可】
2013 Geerts et al.; licensee BioMed Central Ltd.
【 预 览 】
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【 参考文献 】
- [1]Lieberman JA, Stroup TS, McEvoy JP, Swartz MS, Rosenheck RA, Perkins DO, Keefe RS, Davis SM, Davis CE, Lebowitz BD, Severe J, Hsiao JK: Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Investigators: Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005, 353:1209-1223.
- [2]Stroup TS, McEvoy JP, Swartz MS, Byerly MJ, Glick ID, Canive JM, McGee MF, Simpson GM, Stevens MC, Lieberman JA: The National Institute of Mental Health Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) project: schizophrenia trial design and protocol development. Schizophr Bull 2003, 29:15-31.
- [3]Fleischhacker WW, Keet IPM, Kahn RS: The European First Episode Schizophrenia Trial (EUFEST): rationale and design of the trial. Schizophr Res 2005, 78:147-156.
- [4]Perkins DO, Hongbin G, Weiden PJ, McEvoy JP, Hamer RM, Lieberman JA, Comparison of Atypicals in First Episode study group: Predictors of treatment discontinuation and medication nonadherence in patients recovering from a first episode of schizophrenia, schizophreniform disorder, or schizoaffective disorder: a randomized, double-blind, flexible-dose, multicenter study. J Clin Psychiatry 2008, 69:106-113.
- [5]Robinson D, Woerner MG, Alvir JM, Bilder R, Goldman R, Geisler S, Koreen A, Sheitman B, Chakos M, Mayerhoff D, Liberman JA: Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder. Arch Gen Psychiatry 1999, 56:241-247.
- [6]Novick D, Haro JM, Suarez D, Perez V, Dittmann RW, Haddad PM: Predictors and clinical consequences of non-adherence with antipsychotic medication in the outpatient treatment of schizophrenia. Psychiatry Res 2010, 176:109-113.
- [7]Wiersma D, Nienhuis FJ, Slooff CJ, Giel R: Natural course of schizophrenic disorders: a 15-year follow-up of a Dutch incidence cohort. Schizophr Bull 1998, 24:75-85.
- [8]Weiden PJ, Kozma C, Grogg A, Locklear J: Partial compliance and risk of rehospitalization among California Medicaid patients with schizophrenia. Psychiatr Serv 2004, 55:886-891.
- [9]Ascher-Svanum H, Faries DE, Zhu B, Ernst FR, Swartz MS, Swanson JW: Medication adherence and long-term functional outcomes in the treatment of schizophrenia in usual care. J Clin Psychiatry 2006, 67:453-460.
- [10]Masand PS, Roca M, Turner MS, Kane JM: Partial adherence to antipsychotic medication impacts the course of illness in patients with schizophrenia: a review. Prim Care Companion J Clin Psychiatr 2009, 11:147-154.
- [11]Velligan DI, Weiden PJ, Sajatovic M, Carpenter D, Ross R, Docherty JP: Expert Consensus Panel on Adherence Problems in Serious and Persistent Mental Illness: The expert consensus guideline series: adherence problems in patients with serious and persistent mental illness. J Clin Psychiatry 2009, 70(Suppl 4):1-46.
- [12]Herings RM, Erkens JA: Increased suicide attempt rate among patients interrupting use of atypical antipsychotics. Pharmacoepidemiol Drug Saf 2003, 12:423-424.
- [13]Alia-Klein N, O’Rourke TM, Goldstein RZ, Malaspina D: Insight into illness and adherence to psychotropic medications are separately associated with violence severity in a forensic sample. Aggress Behav 2007, 33:86-96.
- [14]Knapp M, King D, Pugner K, Lapuerta P: Non-adherence to antipsychotic medication regimens: associations with resource use and costs. Br J Psychiatry 2004, 184:509-516.
- [15]Gilmer TP, Dolder CR, Lacro JP, Folsom DP, Lindamer L, Garcia P, Jeste DV: Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia. Am J Psychiatry 2004, 161:692-699.
- [16]Sun SX, Liu GG, Christensen DB, Fu AZ: Review and analysis of hospitalization costs associated with antipsychotic nonadherence in the treatment of schizophrenia in the United States. Curr Med Res Opin 2007, 23:2305-2312.
- [17]Gerlach J: Oral versus depot administration of neuroleptics in relapse prevention. Acta Psychiatr Scand Suppl 1994, 382:28-32.
- [18]NICE Clinical Guideline 82 – Schizophrenia. 2009.
- [19]McEvoy JP: Risks versus benefits of different types of long-acting injectable antipsychotics. J Clin Psychiatry 2006, 67(Suppl 5):15-18.
- [20]Peuskens J, Olivares JM, Pecenak J, Tuma I, Bij de Weg H, Eriksson L, Resseler S, Akhras K, Jacobs A: Treatment retention with risperidone long-acting injection: 24-month results from the Electronic Schizophrenia Treatment Adherence Registry (e-STAR) in six countries. Curr Med Res Opin 2010, 26:501-509.
- [21]Peuskens J, Mertens C, Kusters J, Paquet V, Van der Veken J, Jacobs A: Long-acting risperidone in the treatment of schizophrenia: data from a 24-month Belgian electronic schizophrenia adherence registry (eSTAR): an observational study. Acta Psychiatr Belg 2010, 110:34-46.
- [22]Emsley R, Oosthuizen P, Koen L, Niehaus DJ, Medori R, Rabinowitz J: Oral versus injectable antipsychotic treatment in early psychosis: post hoc comparison of two studies. Clin Ther 2008, 30:2378-2386.
- [23]Kane JM, Detke HC, Naber D, Sethuraman G, Lin DY, Bergstrom RF, McDonnell D: Olanzapine long-acting injection: a 24-week, randomized, double-blind trial of maintenance treatment in patients with schizophrenia. Am J Psychiatry 2010, 167:181-189.
- [24]Gaebel W, Schreiner A, Bergmans P, de Arce R, Rouillon F, Cordes J, Eriksson L, Smeraldi E: Relapse prevention in schizophrenia and schizoaffective disorder with risperidone long-acting injectable vs quetiapine: results of a long-term, open-label, randomized clinical trial. Neuropsychopharmacology 2010, 35:2367-2377.
- [25]Pandarakalam JP: The long-acting depot antipsychotic drugs. Hosp Med 2003, 64:603-607.
- [26]Risperdal™ Consta™ Summary of Product Characteristics: Janssen Pharmaceuticals. Bucks, UK: High Wycombe; 2010.
- [27]Thyssen A, Rusch S, Herben V, Quiroz J, Mannaert E: Risperidone long-acting injection: pharmacokinetics following administration in deltoid versus gluteal muscle in schizophrenic patients. J Clin Pharmacol 2010, 50:1011-1021.
- [28]Zypadhera™ Summary of Product Characteristics. Houten, The Netherlands: Eli Lilly Nederland BV; 2008.
- [29]Invega® Sustenna® Product Information. Titusville, NJ, USA: Janssen Pharmaceuticals; 2010.
- [30]Xeplion™ Summary of Product Characteristics: Janssen Pharmaceuticals. Bucks, UK: High Wycombe; 2011.
- [31]Heres S, Hamann J, Kissling W, Leucht S: Attitudes of psychiatrists toward antipsychotic depot medication. J Clin Psychiatry 2006, 67:1948-1953.
- [32]Jaeger M, Rossler W: Attitudes towards long-acting depot antipsychotics: a survey of patients, relatives and psychiatrists. Psychiatry Res 2010, 175:58-62.
- [33]Heres S, Schmitz FS, Leucht S, Pajonk FG: The attitude of patients towards antipsychotic depot treatment. Int Clin Psychopharmacol 2007, 22:275-282.
- [34]Patel MX, De Zoysa N, Bernadt M, David A: Depot and oral antipsychotics: patient preferences and attitudes are not the same thing. J Psychopharmacol 2009, 23:789-796.
- [35]Caroli F, Raymondet P, Izard I, Plas J, Gall B, Delgado A: Opinions of French patients with schizophrenia regarding injectable medication. Patient Prefer Adherence 2011, 5:165-171.
- [36]Patel MX, Haddad PM, Chaudhry IB, McLoughlin S, Husain N, David AS: Psychiatrists' use, knowledge and attitudes to first- and second-generation antipsychotic long-acting injections: comparisons over 5 years. J Psychopharmacol 2010, 24:1473-1482.
- [37]Waddell L, Taylor M: Attitudes of patients and mental health staff to antipsychotic long-acting injections: systematic review. Br J Psychiatry Suppl 2009, 195:s43-s50.
- [38]The Gale Encyclopedia of Nursing and Allied Health (Five Volume Set). Thomson Gale 2001 edition;
- [39]Hough D, Lindenmayer JP, Gopal S, Melkote R, Lim P, Herben V, Yuen E, Eerdekens M: Safety and tolerability of deltoid and gluteal injections of paliperidone palmitate in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2009, 33:1022-1031.
- [40]Ryan M, Farrar S: Using conjoint analysis to elicit preferences for healthcare. BMJ 2000, 320:1530-1533.
- [41]Valenstein M, Ganoczy D, McCarthy JF, Myra Kim H, Lee TA, Blow FC: Antipsychotic adherence over time among patients receiving treatment for schizophrenia: a retrospective review. J Clin Psychiatry 2006, 67:1542-1550.
- [42]Alonso J, Croudace T, Brown J, Gasquet I, Knapp MR, Suárez D, Novick D: Health-related quality of life (HRQL) and continuous antipsychotic treatment: 3-year results from the Schizophrenia Health Outcomes (SOHO) study. Value Health 2009, 12:536-543.
- [43]Patel MX, Nikolaou V, David AS: Psychiatrists' attitudes to maintenance medication for patients with schizophrenia. Psychol Med 2003, 33:83-89.
- [44]Patel MX, DE Zoysa N, Baker D, David AS: Antipsychotic depot medication and attitudes of community psychiatric nurses. J Psychiatr Ment Health Nurs 2005, 12:237-244.
- [45]Lloyd K, Latif MA, Simpson S, Shrestha KL: Switching stable patients with schizophrenia from depot and oral antipsychotics to long-acting injectable risperidone: efficacy, quality of life and functional outcome. Hum Psychopharmacol 2010, 25:243-252.
- [46]Macfadden W, Bossie CA, Turkoz I, Haskins JT: Risperidone long-acting therapy in stable patients with recently diagnosed schizophrenia. Int Clin Psychopharmacol 2010, 25:75-82.
- [47]Rossi A, Bagalà A, Del Curatolo V, Scapati F, Bernareggi MM, Giustra MG: Risperidone Long-Acting Trial Investigators (R-LAI): Remission in schizophrenia: one-year Italian prospective study of risperidone long-acting injectable (RLAI) in patients with schizophrenia or schizoaffective disorder. Hum Psychopharmacol 2009, 24:574-583.
- [48]Pandina GJ, Lindenmayer JP, Lull J, Lim P, Gopal S, Herben V, Kusumakar V, Yuen E, Palumbo J: A randomized, placebo-controlled study to assess the efficacy and safety of 3 doses of paliperidone palmitate in adults with acutely exacerbated schizophrenia. J Clin Psychopharmacol 2010, 30:235-244.
- [49]Nasrallah HA, Gopal S, Gassmann-Mayer C, Quiroz JA, Lim P, Eerdekens M, Yuen E, Hough D: A controlled, evidence-based trial of paliperidone palmitate, a long-acting injectable antipsychotic, in schizophrenia. Neuropsychopharmacology 2010, 35:2072-2082.
- [50]Gopal S, Vijapurkar U, Lim P, Morozova M, Eerdekens M, Hough D: A 52-week open-label study of the safety and tolerability of paliperidone palmitate in patients with schizophrenia. J Psychopharmacol 2011, 25:686-697.
- [51]Kramer M, Litman R, Hough D, Lane R, Lim P, Liu Y, Eerdekens M: Paliperidone palmitate, a potential long-acting treatment for patients with schizophrenia. Results of a randomized, double-blind, placebo-controlled efficacy and safety study. Int J Neuropsychopharmacol 2010, 13:635-647.