title: Barriers to utilizing long-acting injectable antipsychotic medications.
abstract: BACKGROUND
  Long-acting injectable (LAI) antipsychotic medications are superior to their oral equivalents in reducing relapse, yet schizophrenia treatment guidelines favor oral formulations. A minority of eligible patients receive LAI preparations in the United States. The purpose of the present study is to examine barriers faced by psychiatrists in implementing the use of LAI antipsychotics.
  
  
  METHODS
  An internet survey sent to Michigan State University-affiliated psychiatrists examined psychiatrists’ practice locations and characteristics, access, opinions, and barriers to utilizing LAI antipsychotic medications in patients with schizophrenia. Thirty-six psychiatrists completed the survey.
  
  
  RESULTS
  Thirty-three psychiatrists (83%) acknowledged having patients in their practices who would benefit from LAI antipsychotics; however, only 22 (61%) had the capacity to utilize these formulations. Barriers to utilizing LAI antipsychotic medications included: 1) lack of ancillary support at the practice location; 2) personal preference for oral compounds; and 3) limited insurance coverage. Psychiatrists who had the capability of administering LAI antipsychotic compounds were 10 times more likely to utilize them when compared with others who lacked the capacity to do so (9.67% [SD=10] vs 1.43% [SD=3]; df=1; F=8.59; P<.005).
  
  
  CONCLUSIONS
  Psychiatrists practicing in Michigan face formidable barriers to utilizing LAI agents. Strategies to mitigate these barriers are reviewed.
authors.forename: Hayley
authors.initials: H
authors.lastname: Getzen
authors.forename: Marie
authors.initials: M
authors.lastname: Beasley
authors.forename: Dale A
authors.initials: DA
authors.lastname: D'Mello
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000191:economics; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000191:economics; D006801:Humans; D007267:Injections / Q000191:economics / Q000592:standards; D007348:Insurance, Health / Q000191:economics / Q000592:standards; D008605:Mental Health Services / Q000191:economics / Q000592:standards; D008824:Michigan; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000592:standards*; D011570:Psychiatry / Q000191:economics / Q000592:standards*
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations