A Descriptive Study on Patient Profiles and Prescribing Trends of Long-acting Injectable Antipsychotics at the Georgetown Public Hospital from January 2015 to December 2023
Introduction
Long-acting injectable antipsychotics (LAI) drugs primarily aim to address the
prevalent problem of non-adherence among patients on antipsychotic treatment.
Objectives
To describe the characteristics of patients prescribed long-acting injectable
antipsychotics (LAI), as well as the prescribing practices at the Georgetown Public Hospital
Corporation’s Psychiatric clinic.
Method
A retrospective, observational study was done by chart review of
sociodemographic, clinical and prescription data. Population=862; sample size=343. The
Chi-square test and t-test were used for categorical and continuous variables respectively.
A significance level of p≤0.05 was established. All statistical analyses were conducted using
R programming language version 4.40.
Results
The mean age of the study sample was 40.02 years (SD ±13.05 years). The majority
were male (63.8%), African descent (56.0%), unemployed (56.6%) and single (79.6%). The age
difference between the Fluphenazine and Zuclopenthixol groups was statistically significant
(p<0.001). The prevalences of Fluphenazine Decanoate and Zuclopenthixol Decanoate were
62.1% and 37.9% respectively. Schizophrenia spectrum & other psychotic disorders was the
most common diagnosis (63.8%) and non-compliance (37.3%) was the most common
indication for LAI use (37.3%). Fluphenazine Decanoate prescription was associated with a
longer duration of illness and treatment (p<0.001), and once-monthly dose frequency
(p=0.001); Zuclopenthixol Decanoate use was associated with psychiatric comorbidities
(p=0.049) and non-compliance (p<0.001). Polypharmacy prevalence was 88.05%. The
duration of LAI treatment was ≥3 years.
Conclusion
The study found that LAIs were predominantly prescribed to male patients
under 45 years of age who are unemployed and single. The demographic makeup associated
with LAI use generally fell in line with the typical findings in other regions. The prescribing
patterns at the clinic, namely polypharmacy and off-label prescribing being common
among the sample suggest issues such as drug availability.
Recommendations
Clinical documentation improvement, the addition of newer LAI drug
class to the formulary, and research on patient and prescriber preference, as well as on
treatment outcomes.
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