Abstract
Administration of long-acting injectable antipsychotics (LAI) may secure adherence with prescribed medication and thus reduce relapse and rehospitalization rates in schizophrenia. Despite their obvious benefits, LAI remain underutilized in clinical practice.
The aim of our study was to examine the role of LAI in treatment of psychotic disorders in the Czech Republic (CZ), their perception and preference of specific drugs by the psychiatrists. A structured questionnaire covering (1) subjective views on the role of LAI in CZ, (2) personal experiences with LAI, (3) subjective perception of LAI treatment, and (4) basic demographic data was developed and sent out to randomly selected Czech outpatient and inpatient psychiatrists.
The total number of responses was 50. Majority of the responders (56%) used LAI regularly, 74% of them believed their utilization was insufficient.
Switch to LAI and their dose adjustments were considered as not complicated, LAI were not associated with higher rates of side effects, did not stigmatize patients, and did not interfere with therapeutic alliance. Most frequently prescribed LAI were typical, flupenthixol ranking as number one.
The psychiatrists deemed high costs, complicated prescription and reimbursement mechanisms, organization of administration and other administrative issues as the main barriers preventing from higher use of atypical LAI in practice. Responders viewed LAI as suitable either for non-cooperative, non-adherent, frequently relapsing and chronic patients, or for cooperative and educated patients.
Subject of further discussion is their potential administration in early phases of illness and in bipolar disorder, as well.