title: Barriers to the Use of Long-Acting Injectable Antipsychotics in the Management of Schizophrenia.
abstract: Schizophrenia and related disorders remain major disabling conditions, mainly due to antipsychotic treatment resistance and to relapses related to antipsychotic nonadherence. Treatment nonadherence rates are consistently high in long-term patients, but also in first-episode patients with schizophrenia. Long-acting injectable antipsychotics (LAIAs) were mainly developed to improve adherence to treatment and to reduce the rate of relapse and rehospitalization in schizophrenia due to treatment discontinuation. There is favorable clinical evidence, in terms of both efficacy and treatment adherence, that could support higher LAIA prescription rates, especially in patients in early phases of psychotic disorders. Several factors could be hindering wider use of LAIAs, mainly associated with perceptions and attitudes of patients, clinicians, and health managers or policy makers. The main aims of this review are (i) to summarize the existing data on the efficacy and tolerability of LAIAs compared with oral formulations in the management of schizophrenia and related disorders, focusing on the novel, second-generation LAIA options; (ii) to analyze the barriers that exist to the more widespread use of these formulations; and (iii) to discuss possible approaches to overcoming these barriers.
authors.affiliation: Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic de Barcelona, C. Villarroel 170 (Esc 9 Pta 6), 08036, Barcelona, Spain. EPARELLA@clinic.ub.es.|Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Barcelona, Spain. EPARELLA@clinic.ub.es.|Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. EPARELLA@clinic.ub.es.|Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), G04, Barcelona, Spain. EPARELLA@clinic.ub.es.
authors.forename: Eduard
authors.initials: E
authors.lastname: Parellada
authors.affiliation: Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic de Barcelona, C. Villarroel 170 (Esc 9 Pta 6), 08036, Barcelona, Spain.|Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), G04, Barcelona, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Bioque
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002626:Chemistry, Pharmaceutical / Q000379:methods; D003692:Delayed-Action Preparations / Q000627:therapeutic use*; D006801:Humans; D007267:Injections / Q000379:methods; D011618:Psychotic Disorders / Q000188:drug therapy; D012559:Schizophrenia / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations