Original Research

Prescribing patterns of long-acting injectable antipsychotics in a community setting in South Africa

Nabila Veyej, Mahomed Y.H. Moosa
South African Journal of Psychiatry | Vol 28 | a1809 | DOI: https://doi.org/10.4102/sajpsychiatry.v28i0.1809 | © 2022 Nabila Veyej, Mahomed Y.H. Moosa | This work is licensed under CC Attribution 4.0
Submitted: 21 September 2021 | Published: 30 June 2022

About the author(s)

Nabila Veyej, Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Mahomed Y.H. Moosa, Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa


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Abstract

Background: Long-acting injectable antipsychotics (LAI – APs) improve adherence to antipsychotics and decrease functional decline in schizophrenia. Yet they are prescribed late, in patients with established functional decline. Although LAI – APs are widely prescribed in South Africa, there is a paucity of research regarding the prescription profile for LAI – APs.

Aim: This study aimed to describe prescribing practices for LAI – APs at psychiatric clinics.

Setting: Community psychiatric clinics in South Africa.

Methods: A retrospective review of the psychiatric files of all patients on LAI – APs attending the clinics over the study period was conducted. Sociodemographic, clinical and pharmacological information regarding the LAI – AP prescribed was extracted from the files.

Results: A total of 206 charts were examined. The mean age of the study population was 46 (SD ± 12) years. Significantly more patients were male (n = 154; 74.8%), single (n = 184, 89.3%) and unemployed (n = 115; 55.8%) (p < 0.001). Approximately half had a comorbid substance use disorder (47.6%). The most common indication for the prescription of a LAI – AP was non-adherence (66%). Only 9.7% of the patients were prescribed a LAI – AP alone. No significant socio-demographic or clinical characteristic was associated with this prescribing habit. A LAI – AP was prescribed in combination with an oral antipsychotic, mood stabiliser or antidepressant in 53.9%, 44.7% and 7.8% of patients, respectively.

Conclusion: Long-acting injectable antipsychotics were prescribed mainly following noncompliance with oral antipsychotics and may represent a missed opportunity to prevent functional decline. The high prevalence of LAI – AP polypharmacy has been highlighted.


Keywords

long-acting injectable antipsychotics; community clinics; nonadherence; co-prescribing; Africa

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