Innovative strategies to train more psychiatrists and their staff in the use of depot antipsychotics may help promote their use in different settings and in patients whoare less severely ill but are still medication nonadherent.
Less than 20 percent of psychiatrists prescribed a long-acting depot antipsychotic medication for patients with schizophrenia who were nonadherent with the original medication.
That was the finding of a nationwide survey by researchers with the American Psychiatric Institute for Research and Education (APIRE), Columbia University College of Physicians and Surgeons, and the University of Pennsylvania School of Social Policy and Practice. The study was conducted between September 2003 and January 2004.
Moreover, the decision to use depot medications appears to be a function of patient, physician, and practice-setting characteristics. For instance, initiation of depot medication was significantly and positively associated with public insurance, prior inpatient admission, proportion of time nonadherent, average or above average intellectual functioning, and living in a mental health residence. Psychiatrists who were optimistic about managing nonadherence were also more likely to prescribe long-acting antipsychotics for nonadherent patients.
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