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Cited by 81Schizophrenia research and treatmentHealthcare Decision-Making and RestraintsPsychiatric care and mental health services

A qualitative study of experiences with and perceptions regarding long-acting injectable antipsychotics: part II-physician perspectives.

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Iyer, Srividya, Banks, Nicola, Roy, Marc-André, Tibbo, Phil, Williams, Richard, Manchanda, Rahul, Chue, Pierre, Malla, Ashok·2013·The Canadian Journal of Psychiatry
DOI 10.1177/088740341305805s04
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Abstract

Objective: In many countries, including Canada, a small proportion of people with psychotic disorders receive long-acting injectable (LAI) antipsychotics (APs), despite their demonstrated effectiveness and possible advantages for improving adherence rates. Attitudes regarding LAIs among physicians may influence their prescribing practices and thereby contribute to the underuse of LAIs. Here, we report on a qualitative study of perceptions and attitudes toward LAIs among psychiatrists in Canada. Method: Focus groups were conducted with 24 psychiatrists 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 hybrid process of deductive and inductive methods. A brief pre-focus group questionnaire was administered. Results: The pre-focus group questionnaires indicated that psychiatrists in our study prescribed the oral formulation of APs most of the time and had limited experience with LAIs. The focus groups yielded 4 main themes: limited knowledge about and experience with LAIs; attitudes toward LAIs (beliefs about negative perceptions of patients regarding LAIs, personal bias against needles, and consensus about some advantages of LAIs); prescribing practices around LAIs (generally seen as a last-resort option for patients with a history of nonadherence); and pragmatic barriers to using LAIs (for example, cost, storage, and staffing). Conclusion: Several factors may be contributing to the underuse of LAIs and the continuing stigmatized and coercive image of LAIs. Psychiatrists may benefit from better education about LAIs, and from self-examination of their attitudes to LAIs and their prescribing practices.

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  • Surveys of physician attitudes about LAIs show that physicians consider LAIs primarily for patients who have already had repeated hospitalizations and relapses.

    “but surveys of physician attitudes about LAIs show that they consider LAIs primarily for patients who have already had repeated hospitalizations and relapses.11”

    From Effect of Long-Acting Injectable Antipsychotics vs Usual Care on Time to First Hospitalization in Early-Phase Schizophrenia (2020) · cites this paper as [11]

    Prescribing Practices Around LAIs (p. 5) reports that most physicians considered LAIs a last resort, including after multiple relapses, and the Discussion (p. 6) says they may be presented late in treatment. The paper does not establish repeated hospitalizations as a prerequisite, and its own findings come from physician focus groups rather than a survey. (LLM, conf=0.87)

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  • The surveyed psychiatrists mentioned that a lack of confidence around their knowledge of LAI data contributed to the low LAI usage rate in their practices.

    “The surveyed psychiatrists mentioned that a lack of confidence around their knowledge of LAI data contributed to the low LAI usage rate in their practices [105].”

    From Pharmacokinetic Characteristics of Long-Acting Injectable Antipsychotics for Schizophrenia: An Overview (2021) · cites this paper as [105]

  • Data from a qualitative study of physician perspectives collected from focus group sessions among psychiatrists in Canada suggest that some clinicians may have limited knowledge about and experience with LAI antipsychotics, including the different LAIs available, and the evidence supporting their use.

    “Data from a qualitative study of physician perspectives collected from focus group sessions among psychiatrists in Canada suggest that some clinicians may have limited knowledge about and experience with LAI antipsychotics, including the different LAIs available, and the evidence supporting their use [105].”

    From Pharmacokinetic Characteristics of Long-Acting Injectable Antipsychotics for Schizophrenia: An Overview (2021) · cites this paper as [105]

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Research works printed but not linked: 1

  1. [7]7. Johnson DA, Wright NF. Drug prescribing for schizophrenic outpatients on depot injections. Repeat surveys over 18 years. Br J Psychiatry. 1990;156:827-834.

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Authors
Iyer, S., Banks, N., Roy, M.-A., Tibbo, P., Williams, R., Manchanda, R., Chue, P., & Malla, A.
Affiliations
  • Douglas Mental Health University Institute (CA)
  • Myelin & Associates, Hamilton, Ontario.
  • Institut Universitaire en Santé Mentale de Québec (CA)
  • Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia; Director, Nova Scotia Early Psychosis Program, Halifax, Nova Scotia.
  • Island Health (CA)
  • Western University (CA)
  • University of Alberta (CA)
Corresponding author
Malla, Ashok
ORCID
Venue
The Canadian Journal of Psychiatry
Publisher
SAGE Publications
Published
2013-05
Volume
58
Issue
5_suppl
Pages
23-29
ISSN
  • 0706-7437 (ISSN-L)
  • 1497-0015
DOI
10.1177/088740341305805s04
OpenAlex
W1601115002
Semantic Scholar
69548b9454b6ae94b3be3a545079e572b1dc1d12
Cited by
81
References
64
Citations by year
2026: 5 · 2025: 6 · 2024: 3 · 2023: 5 · 2022: 4 · 2021: 12 · 2020: 6 · 2019: 13 · 2018: 6 · 2017: 5 · 2016: 7 · 2015: 6 · 2014: 1 · 2013: 1 · 2012: 1
FWCI
3.54
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • The Canadian Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship@McGill (McGill) (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Keywords
long-acting injectable antipsychotics, physician attitudes, prescribing patterns, medication adherence, psychosis, psychiatric training, psychiatrists
MeSH terms
Administration, Oral, Attitude of Health Personnel, Canada, Delayed-Action Preparations, Female, Humans, Injections, Intramuscular, Male, Practice Patterns, Physicians', Psychiatry, Schizophrenia, Schizophrenic Psychology, Antipsychotic Agents, Focus Groups, Qualitative Research, Medication Therapy Management, Medication Adherence

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