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November 01, 2021
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Most LAI antipsychotic prescribers report pandemic has not affected prescribing

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Most frequent prescribers of long-acting injectable antipsychotics reported no changes in prescribing during the COVID-19 pandemic, according to results of a health care provider survey study presented at Psych Congress.

However, certain factors did affect long-acting injectable (LAI) antipsychotic prescribing among some providers.

infographic with percentage of prescibers who reported no change to LAI prescribing related to pandemic
Infographic data derived from: Monaghan S, et al. Changes in prescribing habits for long-acting injectable antipsychotics in the United States due to the COVID-19 pandemic: Results from a health care provider survey. Presented at: Psych Congress; Oct. 29-Nov. 1, 2021; San Antonio (hybrid meeting).

“Administration of prescribed LAIs by health care providers is an in-person encounter essential for the stability of patients with schizophrenia,” Sophia Monaghan, a global COVID-19 vaccine education lead at Janssen Pharmaceutical Companies of Johnson & Johnson, said during a virtual presentation. “The pandemic has put such encounters at risk, which may negatively affect adherence and symptom control. With this survey of U.S.-based health care providers, we aimed to evaluate changes in LAI prescribing due to the pandemic and explore changes expected in 2021 among health care providers routinely using LAIs for the treatment of schizophrenia.”

Monaghan and colleagues obtained nationwide data between Nov. 17, 2020, and Dec. 12, 2020, via an anonymous, cross-sectional, double-blinded online survey of 408 U.S.-based LAI prescribers with a primary specialty in psychiatry who treated at least one patient with LAIs per month. Participants provided data related to their characteristics and clinical practice, factors that altered LAI prescribing during the pandemic and factors that altered the expected change in LAI prescribing in 2021. Among frequent prescribers, 77.7% were physicians, 17.2% were nurse practitioners and 5.1% were physician assistants, with most (59.1%) having more than 10 years of practice in psychiatry. Regarding practice settings, 27.9% report practicing in community health centers, 22.8% in private practice and 15.2% in inpatient units of psychiatric hospitals. Most (92.7%) clinical practice settings were in urban areas or urban clusters, whereas 7.1% were in rural areas.

Results showed 59.8% of prescribers reported unchanged LAI prescribing rates during the pandemic, whereas 17.6% reported a decrease and 13.7% an increase. Providers who reported unchanged prescribing noted patient concerns with COVID-19 exposure (56.6%) and transportation (45.5%), as well as staff concerns with COVID-19 exposure, as factors that affected the dynamics of LAI prescribing. Those who reported a decrease in prescribing cited patient (55.6%) and staff concerns (45.8%) with COVID-19 exposure as significant factors that affected the dynamics of prescribing, as well as facility closure or reduced visits (43.1%) and patients concerns with transportation (43.1%). Those who reported increased prescribing cited patient concerns with transportation (44.6%) and increased confidence in LAI adherence (44.6%) as common factors linked to prescribing.

Comparable numbers of frequent prescribers expected no change (44.1%) or an increase (42.9%) in LAI prescribing rates in 2021; however, only 3.4% expected a decrease. Those who expected no change in prescribing cited the cost of treatment for patients (45%), clinical staff availability to administer LAIs onsite (38.9%) and the number of patients with schizophrenia followed at their clinical practice (37.8%) as common factors that affect the anticipated prescribing dynamics. Common factors among those who reported an expected increase included the number of patients with schizophrenia followed at their clinical practice (36), the cost of treatment for patients (36%) and clinical staff availability to administer LAIs onsite (33.7%), and those who reported an expected decrease cited clinical staff availability to administer LAIs onsite (57.1%).

“The majority of frequent LAI prescribers surveyed reported that their LAI prescribing remained unchanged during the COVID-19 pandemic,” Monaghan said.