Use of depot antipsychotic medications for medication nonadherence in schizophrenia.
OBJECTIVE
To describe factors associated with initiation of depot antipsychotic medications in psychiatric outpatients with schizophrenia and recent medication nonadherence.


METHODS
A national sample of psychiatrists reported on adult outpatients with schizophrenia who were nonadherent with oral antipsychotic medications in the last year.


RESULTS
In total, 17.6% of psychiatrists initiated depot antipsychotic injections. Initiation was significantly and positively associated with public insurance, prior inpatient admission, proportion of time nonadherent, average or above average intellectual functioning, and living in a mental health residence. Use was inversely associated with using second-generation antipsychotics and other oral psychotropic medications prior to medication nonadherence. Psychiatrists who were male, nonwhite, and more optimistic about managing nonadherence were more likely to initiate depot injections.


CONCLUSIONS
Initiation of depot injections is a joint function of patient, physician, treatment, and setting factors. Use of long-acting preparations in this population is uncommon despite clinical recommendations urging their use.
West
Joyce C
JC
American Psychiatric Institute for Research and Education, Arlington, VA, USA.
Marcus
Steven C
SC
Wilk
Joshua
J
Countis
Lisa M
LM
Regier
Darrel A
DA
Olfson
Mark
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology*
D014150:Antipsychotic Agents