A qualitative study of experiences with and perceptions regarding long-acting injectable antipsychotics: Part I-patient perspectives.
OBJECTIVE
Despite the well-acknowledged problem of poor adherence to antipsychotic (AP) medication, long-acting injectables (LAIs) that could improve adherence are underused in Canada. Attitudes concerning LAIs among patients and psychiatrists may contribute to this underuse. Our objective was to investigate perceptions of and attitudes toward LAIs among patients in Canada.


METHODS
Focus groups were conducted with 34 patients with a diagnosis of schizophrenia spectrum psychoses in 4 Canadian provinces. The focus groups inquired about experiences with and attitudes toward LAI APs. The sessions were audiotaped and transcribed verbatim, and transcripts were coded using a combination of deductive and inductive methods.


RESULTS
Four themes emerged: awareness of and knowledge about LAIs; perceptions about LAIs; cost and convenience considerations; and issues arising from the coercive context under which LAIs were often prescribed. Nine patients had never heard about LAIs, and some others reported not having understood what was discussed with them regarding LAIs. Patients had typically heard about LAIs in either a context of coercion or of medication nonadherence. Patients had positive and negative perceptions concerning LAIs. The positive perceptions centred on relapse prevention and reduced effort in ensuring adherence, and the negative perceptions centred on financial costs and the inconvenience of appointments to receive injections.


CONCLUSIONS
To enhance LAI usage, some of the issues that need to be addressed are the inadequacy of information given to patients, the element of coercion involved in LAI introduction, the pragmatic barriers to LAI uptake by patients, and negative subjective perceptions about LAIs.
Department of Psychiatry, McGill University, Montreal, Quebec.
Srividya
S
Iyer
Nicola
N
Banks
Marc-André
MA
Roy
Phil
P
Tibbo
Richard
R
Williams
Rahul
R
Manchanda
Pierre
P
Chue
Ashok
A
Malla
D000284:Administration, Oral; D000328:Adult; D014150:Antipsychotic Agents / Q000145:classification / Q000191:economics / Q000627:therapeutic use; D002170:Canada; D003692:Delayed-Action Preparations / Q000627:therapeutic use*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007273:Injections, Intramuscular / Q000523:psychology; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D054539:Medication Therapy Management; D063046:Patient Medication Knowledge; D010358:Patient Participation; D057240:Patient Preference; D011306:Prescription Fees; D036301:Qualitative Research; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology
D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations
antipsychotic long-acting injections; focus group; long-acting depot antipsychotics; patient attitudes