Impact of long-acting injectable antipsychotics on medication adherence and clinical, functional, and economic outcomes of schizophrenia
Open accessAbstract
Schizophrenia is a debilitating chronic disease that requires lifelong medical care and supervision. Even with treatment, the majority of patients relapse within 5 years, and suicide may occur in up to 10% of patients. Poor adherence to oral antipsychotics is the most common cause of relapse. The discontinuation rate for oral antipsychotics in schizophrenia ranges from 26% to 44%, and as many as two-thirds of patients are at least partially nonadherent, resulting in increased risk of hospitalization. A very helpful approach to improve adherence in schizophrenia is the use of long-acting injectable (LAI) antipsychotics, although only a minority of patients receive these. Reasons for underutilization may include negative attitudes, perceptions, and beliefs of both patients and health care professionals. Research shows, however, significant improvements in adherence with LAIs compared with oral drugs, and this is accompanied by lower rates of discontinuation, relapse, and hospitalization. In addition, LAIs are associated with better functioning, quality of life, and patient satisfaction. A need exists to encourage broader LAI use, especially among patients with a history of nonadherence with oral antipsychotics. This paper reviews the impact of nonadherence with antipsychotic drug therapy overall, as well as specific outcomes of the schizophrenia patient, and highlights the potential benefits of LAIs.
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Estimates of discontinuation rates for oral antipsychotics range from 26 to 44%, with as many as two-thirds of patients being at least partially nonadherent.
“Estimates of discontinuation rates for oral antipsychotics range from 26 to 44%, with as many as two-thirds of patients being at least partially nonadherent [4].”
From Pharmacokinetic Characteristics of Long-Acting Injectable Antipsychotics for Schizophrenia: An Overview (2021) · cites this paper as [4]
In “Impact of medication adherence on schizophrenia,” the paper reports that 26%–44% discontinued medication during the first year after a first episode of psychosis, and that as many as two-thirds are at least partially nonadherent to oral schizophrenia medication. The citing sentence omits the first-year, first-episode restriction on the discontinuation estimate and presents it as a general range for oral antipsychotics. (LLM, conf=0.86)
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References 93 · Cited by 201
- Authors
- Kaplan, G., Casoy, J., & Zummo, J.
- Affiliations
- Rutgers New Jersey Medical School (US)
- Alkermes (United States) (US)
- Corresponding author
- Kaplan, Gabriel
- ORCID
- Zummo, Jacqueline
- Venue
- Patient Preference and Adherence
- Publisher
- Informa UK Limited
- Published
- 2013-11
- Volume
- 7
- Pages
- 1171
- ISSN
- 1177-889X (ISSN-L)
- PMC
- PMC3833623
- OpenAlex
- W1989794259
- Cited by
- 201
- References
- 93
- Citations by year
- 2026: 10 · 2025: 28 · 2024: 18 · 2023: 21 · 2022: 12 · 2021: 23 · 2020: 11 · 2019: 17 · 2018: 21 · 2017: 11 · 2016: 12 · 2015: 7 · 2014: 10
- FWCI
- 1.32
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Patient Preference and Adherence (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
- Keywords
- long-acting injectable antipsychotics, schizophrenia, medication adherence, oral antipsychotics, relapse, hospitalization, treatment discontinuation, functional outcome, quality of life, patient satisfaction, economic outcomes
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