Clinical Decision-Making in the Treatment of Schizophrenia: Focus on Long-Acting Injectable Antipsychotics
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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.
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The advent of LAIs appeared to overcome poor adherence but did not solve the widespread lack of adherence because LAIs remain largely underutilized.
“The advent of new long-acting injectable antipsychotics (LAIs) had appeared to overcome the issue of poor adherence [21–24], but did not solve the widespread lack of adherence, as these drugs still remain largely underutilized.”
From The role of shared decision-making in improving adherence to pharmacological treatments in patients with schizophrenia: A clinical review (2020) · cites this paper as [24]
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- Authors
- Samalin, L., Garnier, M., Auclair, C., & Llorca, P.-M.
- Affiliations
- Université Clermont Auvergne (FR)
- Centre Hospitalier et Universitaire, Department of Public Health, University of Auvergne, EA 4681 PEPRADE, 63000 Clermont-Ferrand, France
- Corresponding author
- Llorca, Pierre-Michel
- Venue
- International Journal of Molecular Sciences
- Publisher
- MDPI AG
- Published
- 2016-11-19
- Volume
- 17
- Issue
- 11
- Pages
- 1935
- ISSN
- 1422-0067 (ISSN-L)
- PMC
- PMC5133930
- OpenAlex
- W2553460568
- Cited by
- 23
- References
- 29
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 1 · 2018: 4 · 2017: 2
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Molecular Sciences (publishedVersion, cc-by)
- Preprints.org (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- long-acting injectable antipsychotics, schizophrenia, clinical decision-making, psychiatrists, prescription rates, atypical antipsychotics, oral antipsychotics, clinician characteristics, treatment guidelines, regulatory approval, clinical experience
- MeSH terms
- Clinical Decision-Making, Administration, Oral, Adult, Delayed-Action Preparations, France, Humans, Injections, Intramuscular, Male, Middle Aged, Practice Patterns, Physicians', Drug Prescriptions, Psychiatry, Surveys and Questionnaires, Schizophrenia, Antipsychotic Agents, Practice Guidelines as Topic, Disease Management
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