(#46) Perspectives of Psychiatrists and Psychiatric Nonphysicians on Treating Schizophrenia With Long-Acting Injectable Antipsychotics: Subgroup Analysis From the Multinational ADVANCE Study

Abstract: Background: Long-acting injectable antipsychotics (LAIs) improve adherence and reduce relapse compared with oral antipsychotics, but LAI use varies. This analysis of the Attitudes DriVing regional differences in LAI ANtipsychotic utilization for schizophrenia among healthcare professionals (HCPs), patients, and CaregivErs (ADVANCE) study aimed to understand perspectives on LAIs among psychiatric clinicians. Methods: The multinational ADVANCE study surveyed HCPs in 8 countries who spent ?25% of their time providing direct patient care, managed ?10% adults with schizophrenia monthly, and reported treating patients with second-generation LAIs. Results: Of 791 HCPs, 62% were psychiatrists; 38% were nonphysicians. Nonphysicians managed patients with schizophrenia more commonly in inpatient settings than psychiatrists (40% vs 29%). Psychiatrists often reported using LAIs early in the disease (48%); nonphysicians frequently reserved LAIs for addressing nonadherence (38%) or severe disease (32%). Psychiatrists were more likely than nonphysicians to initiate an LAI (1=never to 5=very likely; mean rating=4.2 vs 4.0) and were more confident in determining when to initiate LAI (1=not at all to 5=extremely confident; mean rating=3.8 vs 3.6). Psychiatrists reported lower rates of patients accepting an LAI on first recommendation than nonphysicians (33% vs 38%). Nonphysicians spent more time than psychiatrists discussing LAI initiation with patients (mean=23.2 vs 19.7 minutes). Conclusion: Psychiatrists were more likely to initiate an LAI to treat schizophrenia than nonphysicians, though nonphysicians reported that patients accepted an LAI on first recommendation more often. Differences in perspectives on which patients should receive an LAI, practice characteristics, and LAI availability may influence LAI use for psychiatrists vs nonphysicians.Short Description: The multinational study Attitudes DriVing regional differences in LAI ANtipsychotic utilization for schizophrenia among HCPs, patients, and CaregivErs (ADVANCE) included surveys with 791 psychiatrists and psychiatric nonphysicians from 8 countries. Compared with nonphysicians, psychiatrists were more likely to initiate an LAI to treat schizophrenia. Psychiatrists were more confident in recommending LAIs than nonphysicians. Differences in perspectives on which patients should be recommended an LAI and practice characteristics may influence LAI use for psychiatrists vs nonphysicians.Name of Sponsoring Organization(s): Teva Branded Pharmaceutical Products R&D LLC.