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May 25, 2022
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Telemedicine acceptable for patients being treated for schizophrenia

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NEW ORLEANS — Most investigators concluded that telemedicine is satisfactory for patients with schizophrenia being treated with long-acting injectable psychotics, according to survey results presented at the American Psychiatric Association meeting.

O’Sullivan and colleagues set out to evaluate the impact of the COVID-19 pandemic and the role of telepsychiatry on managing this patient population in the fall of 2020.

Source: Adobe Stock.
Source: Adobe Stock.

Co-author Dawn I. Velligan, PhD, of the University of Texas Health Science Center at San Antonio, said this observational study specifically involved patients with schizophrenia transitioning from medication to long-acting injectables (LAIs).

“During COVID-19, all 50 sites had problems,” Velligan told Healio. “We turned this into an opportunity [to evaluate] how clinical management of LAIs change as a result of the impact of the pandemic, because you have to go somewhere and get an injection.”

Thirty-five clinics ended up participating in the survey. Velligan said about half of the sites did not have telemedicine before the pandemic and “they had to gear up quickly.”

The investigators found that about one-third of patients were switched to a longer-acting LAI to reduce the number of injection visits, and another third were switched from LAIs to orals, Velligan said. The instances where patients were switched to orals were primarily due to patients not wanting to come into the clinic for injections or transportation issues.

Some of the clinics “got creative” and administered injections outside, she noted.

The principal investigators reported that 46% of those on orals had issues with adherence to the medication regimen vs. 60% on LAIs, she said.

Velligan noted that concerns related to telemedicine included uncertainty about reimbursement rates and costs of implementation.

“What was frustrating for us was the lack of technology on the part of the patients,” she said. “Sometimes we had to do visits by telephone.”

However, “The sites feel that telemedicine is here to stay, and some kind of hybrid of telemedicine and in-person visits will be the wave of the future.”

According to the study, 94% of the investigators said telepsychiatry maintained the standard of care for patients with schizophrenia who are being treated with LAIs.