Why are long-acting injectable antipsychotics still underused?

Summary‘Depot antipsychotics' (‘long-acting injectable antipsychotic medications' or LAIs) are underused in the treatment of schizophrenia (including first episodes) and, possibly, of schizophrenia with comorbid substance use disorders. Patients' and clinicians' beliefs and attitudes, and service barriers, affect best practice and evidence-based care in LAI prescription. Poor medication adherence is a key reason for LAI prescription, but patients receiving LAIs may still relapse or experience significant side-effects. Patients' and clinicians' attitudes towards antipsychotic medication, as well as the quality of their recovery-focused relationship, are key factors in adherence. Clinicians should avoid a dichotomous ‘oralv. LAI’ choice: LAIs may have a place at various stages in the continuum of care and they should be one of the options discussed with any patient requiring long-term treatment, even early in the illness course. Many clinicians need better education about LAIs and greater familiarity with schizophrenia treatment guidelines.

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The effect of switching from oral low-dose aripiprazole to aripiprazole once-monthly 300 mg on the quality of life in three patients with schizophrenia

SAGE Open Medical Case Reports ◽

10.1177/2050313x17710594 ◽

2017 ◽

Vol 5 ◽

pp. 2050313X1771059 ◽

Cited By ~ 2

Author(s):

Hidenobu Suzuki ◽

Hiroyuki Hibino ◽

Yuichi Inoue ◽

Hideo Matsumoto ◽

Katsunaka Mikami

Keyword(s):

Quality Of Life ◽

Negative Symptoms ◽

Low Dose ◽

Treatment Options ◽

Term Treatment ◽

Long Term Treatment ◽

Important Barrier ◽

Long Acting

Background: Schizophrenia is a chronic disease that requires long-term management with antipsychotics; however, an important barrier to the success of long-term treatment is drug noncompliance, which increases the risk of recurrence and hospitalization. Second-generation long-acting injectable antipsychotics have improved drug adherence, and the pharmacological effects of the drugs, and therefore, have become useful treatment options. Methods: We report on three schizophrenia patients who switched from oral low-dose aripiprazole to aripiprazole once-monthly 300 mg. We examined the efficacy and safety of aripiprazole once-monthly 300 mg, as well as its influence on quality of life, from baseline to 20 weeks after aripiprazole once-monthly 300 mg treatment. Results: Aripiprazole once-monthly 300 mg did not exacerbate the depressive and negative symptoms, and extrapyramidal symptoms were improved, which may have helped improve the quality of life. Conclusion: The results suggest the efficacy of aripiprazole once-monthly 300 mg in maintenance treatment for schizophrenia when mental symptoms are stable.

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Sustained drug delivery optimizes long-term treatment of patients with schizophrenia

Acta Neuropsychiatrica ◽

10.1111/j.0924-2708.2004.00100.x ◽

2004 ◽

Vol 16 (6) ◽

pp. 319-325 ◽

Cited By ~ 2

Author(s):

Pierre S. Chue ◽

Peter D'Hoore ◽

J. Michael Ramstack

Keyword(s):

Antipsychotic Agents ◽

Term Treatment ◽

Treatment Programs ◽

Sustained Drug Delivery ◽

Partial Compliance ◽

Long Term Treatment ◽

Optimal Maintenance ◽

Long Acting ◽

The Impact

Chronic disorders such as schizophrenia require long-term treatment programs in order to maintain patients at the lowest level of symptomatology, reduce the likelihood of psychotic relapse, and support achievement of remission and recovery. Evidence suggests that treatment with long-acting injectable antipsychotics reduces the impact of partial compliance and provides predictable release of medication, assuring continuous therapeutic coverage. Until recently, only conventional antipsychotic agents were available in long-acting formulations, thereby foregoing the advantages of the atypical class. Atypical agents which are given orally have been shown to provide long-term efficacy and tolerability benefits compared with conventional agents, but are limited by the need for daily administration. The most recent pharmacological strategy to achieve optimal maintenance treatment has been to combine the benefits of an atypical antipsychotic with delivery in a water-based long-acting formulation. The first antipsychotic to achieve this combination – long-acting risperidone – may thus represent an important advance in the optimization of long-term treatment outcomes in patients with schizophrenia.

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Distribution of strontium and mineralization in iliac bone biopsies from osteoporotic women treated long-term with strontium ranelate

Acta Endocrinologica ◽

10.1530/eje-11-0415 ◽

2011 ◽

Vol 165 (3) ◽

pp. 469-476 ◽

Cited By ~ 26

Author(s):

Audrey Doublier ◽

Delphine Farlay ◽

Mohamed T Khebbab ◽

Xavier Jaurand ◽

Pierre J Meunier ◽

...

Keyword(s):

Bone Mineralization ◽

Progressive Increase ◽

Tissue Level ◽

Term Treatment ◽

Iliac Bone ◽

X Ray ◽

Long Term Treatment ◽

Bone Biopsies

ObjectiveTo investigate interactions between strontium (Sr) and bone mineral and its effects on mineralization in osteoporotic women treated long-term with Sr ranelate (SrRan).DesignIn this study, 34 iliac bone biopsies were analyzed after 2, 12, 24, 36, 48, and 60 months of treatment with SrRan.MethodsSr global distribution was analyzed by X-ray cartography and the percentage of bone area containing Sr was calculated in the bone samples. The focal distribution of Sr in all bone samples was investigated by X-ray microanalysis. The degree of mineralization was assessed by quantitative microradiography.ResultsAbsent from old bone formed before the beginning of treatment, Sr was exclusively present in bone formed during this treatment with a much higher focal Sr content in new bone structural units than in old ones. A progressive increase in the extent of areas containing Sr was observed during treatment. The focal bone Sr content in recently formed bone was constant over treatment. Secondary mineralization was maintained at a normal level during treatment.ConclusionThus, the quality of bone mineralization (density and heterogeneity at tissue level) was preserved after a long-term treatment with SrRan.

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The crystal arthropathies

InnovAiT Education and inspiration for general practice ◽

10.1177/1755738013499319 ◽

2013 ◽

Vol 6 (11) ◽

pp. 681-687 ◽

Cited By ~ 1

Author(s):

Robert A Jones ◽

Brian Quilty

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Inflammatory Arthritis ◽

Term Treatment ◽

Routine Practice ◽

Treatment Goals ◽

Crystal Arthropathies ◽

Long Term Treatment

Unlike many other forms of inflammatory arthritis, the crystal arthropathies are routinely diagnosed and managed in primary care. Gout, in particular, is relatively commonplace and rates of other types of crystal-related arthritis are predicted to increase. These are, therefore, conditions that GPs and trainees will regularly encounter during routine practice. While the clinical features and pathophysiology of gout and pseudo-gout are well described, the long-term treatment goals and options of management are often less well understood, and opportunities to assess for associated co-morbidities can easily be missed. GPs can be central in optimising management by promptly and appropriately addressing acute symptoms, preventing recurrent attacks, minimising disability and work absences, reducing cardiovascular risk factors, improving general health and enhancing quality of life.

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Concerns and Quality of Life of Cancer Survivors Across the Survivorship Trajectory: A Singapore Perspective

10.21203/rs.2.14780/v1 ◽

2019 ◽

Author(s):

Gek Phin Chua ◽

Quan Sing Ng ◽

Hiang Khoon Tan ◽

Whee Sze Ong

Keyword(s):

Quality Of Life ◽

Cancer Survivors ◽

Cancer Treatment ◽

Cancer Survivorship ◽

Recurrence Risk ◽

Term Treatment ◽

Fear Of Recurrence ◽

Long Term Treatment

Abstract Background The aim of this study is to determine the main concerns of survivors at various stages of the cancer survivorship of the cancer survivorship trajectory and to assess whether these concerns have any effect on their quality of life (QOL). The overall goal was to use the insights from the study to guide practice on patient care. Methods A cross-sectional survey of 1107 cancer survivors diagnosed with colorectal, breast, lung, gynaecological, prostate or liver cancers from a cancer centre in Singapore. Eligible patients self-completed a questionnaire adapted from the Mayo Clinic Cancer Centre’s Cancer Survivors Survey of Needs. Results The top 5 concerns among all survivors were cancer treatment and recurrence risk (51%), followed by long-term treatment effects (49%), fear of recurrence (47%), financial concerns (37%) and fatigue (37%). Cancer treatment and recurrence risk, long-term treatment effects and fear of recurrence were amongst the top concerns across the survivorship trajectory. Mean QOL was 7.3 on a scale of 0 – 10. Completed treatment patients had higher QOL score than the newly diagnosed and on treatment patients and the patients dealing with recurrence or second cancer patients. Predictors for QOL included the economic status and housing type of patients and whether patients were concerned with pain and fatigue Conclusion This study confirms that cancer survivors in Singapore face multiple challenges and had various concerns at various stages of cancer survivorship, some of which negatively affect their QOL It is critical to design patient care delivery that appropriately address the various concerns of cancer survivors in order for them to cope and improve their QOL.

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