title: Clinical Decision-Making in the Treatment of Schizophrenia: Focus on Long-Acting Injectable Antipsychotics.
abstract: The purpose of this study was to identify clinician characteristics associated with higher prescription rates of long-acting injectable (LAI) antipsychotics, as well as the sources that influence medical decision-making regarding the treatment of schizophrenia. We surveyed 202 psychiatrists during six regional French conferences (Bordeaux, Lyon, Marseille, Nice, Paris, and Strasbourg). Data on the characteristics of practice, prescription rates of antipsychotic, and information sources about their clinical decisions were collected. Most psychiatrists used second-generation antipsychotics (SGAs), and preferentially an oral formulation, in the treatment of schizophrenia. LAI SGAs were prescribed to 30.4% of schizophrenic patients. The duration and type of practice did not influence the class or formulation of antipsychotics used. The clinicians following the higher percentage of schizophrenic patients were associated with a higher use of LAI antipsychotics and a lower use of oral SGAs. Personal experience, government regulatory approval, and guidelines for the treatment of schizophrenia were the three main contributing factors guiding clinicians' decision-making regarding the treatment of schizophrenia. The more clinicians follow schizophrenic patients, the more they use LAI antipsychotics. The development of specialized programs with top specialists should lead to better use of LAI antipsychotics in the treatment of schizophrenia.
authors.affiliation: Centre Hospitalier et Universitaire, Department of Psychiatry, University of Auvergne, EA 7280, 63000 Clermont-Ferrand, France. lsamalin@chu-clermontferrand.fr.|French Society for Biological Psychiatry and Neuropsychopharmacology, CH Sainte Anne, 75674 Paris, France. lsamalin@chu-clermontferrand.fr.|Fondation FondaMental, Hôpital Albert Chenevier, Depatment of Psychiatry, 94000 Créteil, France. lsamalin@chu-clermontferrand.fr.
authors.forename: Ludovic
authors.initials: L
authors.lastname: Samalin
authors.affiliation: Centre Hospitalier et Universitaire, Department of Psychiatry, University of Auvergne, EA 7280, 63000 Clermont-Ferrand, France. m_garnier@chu-clermontferrand.fr.|Fondation FondaMental, Hôpital Albert Chenevier, Depatment of Psychiatry, 94000 Créteil, France. m_garnier@chu-clermontferrand.fr.
authors.forename: Marion
authors.initials: M
authors.lastname: Garnier
authors.affiliation: Centre Hospitalier et Universitaire, Department of Public Health, University of Auvergne, EA 4681 PEPRADE, 63000 Clermont-Ferrand, France. cauclair@chu-clermontferrand.fr.
authors.forename: Candy
authors.initials: C
authors.lastname: Auclair
authors.affiliation: Centre Hospitalier et Universitaire, Department of Psychiatry, University of Auvergne, EA 7280, 63000 Clermont-Ferrand, France. pmllorca@chu-clermontferrand.fr.|French Society for Biological Psychiatry and Neuropsychopharmacology, CH Sainte Anne, 75674 Paris, France. pmllorca@chu-clermontferrand.fr.|Fondation FondaMental, Hôpital Albert Chenevier, Depatment of Psychiatry, 94000 Créteil, France. pmllorca@chu-clermontferrand.fr.
authors.forename: Pierre-Michel
authors.initials: PM
authors.lastname: Llorca
mesh_terms: D000284:Administration, Oral; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D000066491:Clinical Decision-Making; D003692:Delayed-Action Preparations / Q000627:therapeutic use*; D019468:Disease Management; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005602:France; D006801:Humans; D007273:Injections, Intramuscular / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011570:Psychiatry; D012559:Schizophrenia / Q000188:drug therapy* / Q000503:physiopathology; D011795:Surveys and Questionnaires
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations
keywords: antipsychotic; decision-making; guidelines; long-acting injectable; schizophrenia