Worth a Shot? Evidence-Based Approach to Prescribing LAI Antipsychotic Medications-View Presentation Slides

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This document outlines a presentation by the American Psychiatric Association on the use of long-acting injectable (LAI) antipsychotics in treating schizophrenia. The focus was on comparing LAIs to oral antipsychotics (OAPs) regarding treatment adherence, effectiveness, and cost-efficiency.<br /><br />The presentation highlighted that patients treated with LAIs often experience better outcomes compared to those on OAPs. Benefits include a lower risk of treatment failure, rehospitalization, medication discontinuation, and death. Studies indicated that LAIs are especially beneficial for patients struggling with adherence due to factors like limited awareness or co-occurring substance use disorders.<br /><br />Evidence suggests that patients transitioning from OAPs to LAIs have better treatment adherence, fewer hospitalizations, and reduced healthcare costs. In particular, second-generation LAIs (SGA-LAIs) were shown to lead to better adherence and persistence than first-generation LAIs (FGA-LAIs) and OAPs, with fewer instances of polypharmacy.<br /><br />The discussion also covered several studies and their findings. For example, a study on paliperidone palmitate suggested it leads to fewer hospitalizations and lower failure events compared to daily oral treatments. Another study pointed out that LAIs could enhance survival times without readmission.<br /><br />Despite positive real-world results seen in observational studies, meta-analysis of randomized controlled trials (RCTs) found no significant advantage of LAIs over OAPs for decreasing relapse rates, demonstrating potential discrepancies in research design effects.<br /><br />Overall, the presentation advocated for considering patient preferences and individual circumstances when choosing between LAI and OAP treatments, with LAIs offering a viable alternative for consistent treatment management in individuals with schizophrenia.

Keywords

long-acting injectable antipsychotics

schizophrenia treatment

oral antipsychotics

treatment adherence

cost-efficiency

second-generation LAIs

paliperidone palmitate

rehospitalization

medication discontinuation

randomized controlled trials