Targets, Attitudes, and Goals of Psychiatrists Treating Patients with Schizophrenia: Key Outcome Drivers, Role of Quality of Life, and Place of Long-acting Antipsychotics

Overview

Journal Neuropsychiatr Dis Treat

Publisher Dove Medical Press

Specialty Psychiatry

Date 2016 Jan 27

PMID 26811682

Citations 5

Authors

Andrea de Bartolomeis

Andrea Fagiolini

Marco Vaggi

Claudio Vampini

Affiliations

Soon will be listed here.

Abstract

Purpose: This survey of Italian psychiatrists was conducted to better define drivers of schizophrenia treatment choice in real-life practice, particularly for use of long-acting injectable (LAI) antipsychotics.

Methods: Between October 15 and December 15, 2014, 1,000 surveys were sent to psychiatrists who treat schizophrenic patients; 709 completed questionnaires were analyzed (71% response rate).

Results: The two most important factors determining therapy success were efficacy (75% of responses) and tolerability (45%) followed by global functioning (24%) and quality of life (17%). LAI antipsychotics were most often used to facilitate regular treatment monitoring (49%), and 41% of psychiatrists thought that patients with low adherence who had failed oral therapy were well-suited for LAI antipsychotics. Only 4% of respondents saw LAI antipsychotics as appropriate for patients without other therapeutic options.

Conclusion: Although efficacy and tolerability were the most common factors used to evaluate treatment success in schizophrenia, psychiatrists also consider QoL and global functioning to be important.

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References

Russo J, Trujillo C, Wingerson D, Decker K, Ries R, Wetzler H . The MOS 36-Item Short Form Health Survey: reliability, validity, and preliminary findings in schizophrenic outpatients. Med Care. 1998; 36(5):752-6. DOI: 10.1097/00005650-199805000-00015. View

Agid O, Foussias G, Remington G . Long-acting injectable antipsychotics in the treatment of schizophrenia: their role in relapse prevention. Expert Opin Pharmacother. 2010; 11(14):2301-17. DOI: 10.1517/14656566.2010.499125. View

Takeuchi H, Suzuki T, Uchida H, Watanabe K, Mimura M . Antipsychotic treatment for schizophrenia in the maintenance phase: a systematic review of the guidelines and algorithms. Schizophr Res. 2011; 134(2-3):219-25. DOI: 10.1016/j.schres.2011.11.021. View

Fujimaki K, Takahashi T, Morinobu S . Association of typical versus atypical antipsychotics with symptoms and quality of life in schizophrenia. PLoS One. 2012; 7(5):e37087. PMC: 3353903. DOI: 10.1371/journal.pone.0037087. View

Keshavan M, Roberts M, Wittmann D . Guidelines for clinical treatment of early course schizophrenia. Curr Psychiatry Rep. 2006; 8(4):329-34. DOI: 10.1007/s11920-006-0070-7. View

Riedel M, Spellmann I, Schennach-Wolff R, Obermeier M, Musil R . The RSM-scale: a pilot study on a new specific scale for self- and observer-rated quality of life in patients with schizophrenia. Qual Life Res. 2010; 20(2):263-72. DOI: 10.1007/s11136-010-9744-z. View

Kwon J, Choi J . Social functioning and quality of life as measures of effectiveness in the treatment of schizophrenia. World Psychiatry. 2009; 8(1):35-6. PMC: 2652897. DOI: 10.1002/j.2051-5545.2009.tb00207.x. View

Chugh P, Rehan H, Unni K, Sah R . Predictive value of symptoms for quality of life in first-episode schizophrenia. Nord J Psychiatry. 2012; 67(3):153-8. DOI: 10.3109/08039488.2012.687768. View

Naber D, Vita A . Tools for measuring clinical effectiveness. Eur Neuropsychopharmacol. 2004; 14 Suppl 4:S435-44. DOI: 10.1016/j.euroneuro.2004.08.002. View

10.

Vothknecht S, Meijer C, Zwinderman A, Kikkert M, Dekker J, van Beveren N . Psychometric evaluation of the Subjective Well-being Under Neuroleptic Treatment Scale (SWN) in patients with schizophrenia, their relatives and controls. Psychiatry Res. 2012; 206(1):62-7. DOI: 10.1016/j.psychres.2012.09.004. View

11.

Bera R . Patient outcomes within schizophrenia treatment: a look at the role of long-acting injectable antipsychotics. J Clin Psychiatry. 2014; 75 Suppl 2:30-3. DOI: 10.4088/JCP.13065su1c.07. View

12.

Edlinger M, Hofer A, Rettenbacher M, Baumgartner S, Widschwendter C, Kemmler G . Factors influencing the choice of new generation antipsychotic medication in the treatment of patients with schizophrenia. Schizophr Res. 2009; 113(2-3):246-51. DOI: 10.1016/j.schres.2009.06.008. View

13.

Araujo A, de Araujo Dantas D, do Nascimento G, Ribeiro S, Chaves K, Silva V . Quality of life in patients with schizophrenia: the impact of socio-economic factors and adverse effects of atypical antipsychotics drugs. Psychiatr Q. 2014; 85(3):357-67. DOI: 10.1007/s11126-014-9290-x. View

14.

Kaplan G, Casoy J, Zummo J . Impact of long-acting injectable antipsychotics on medication adherence and clinical, functional, and economic outcomes of schizophrenia. Patient Prefer Adherence. 2013; 7:1171-80. PMC: 3833623. DOI: 10.2147/PPA.S53795. View

15.

Buckley P . Factors that influence treatment success in schizophrenia. J Clin Psychiatry. 2008; 69 Suppl 3:4-10. View

16.

Su C, Ng H, Yang A, Lin C . Psychometric evaluation of the Short Form 36 Health Survey (SF-36) and the World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF) for patients with schizophrenia. Psychol Assess. 2014; 26(3):980-9. DOI: 10.1037/a0036764. View

17.

van Os J, Kapur S . [Psychosis: from diagnosis to syndrome]. Ned Tijdschr Geneeskd. 2010; 154:A1874. View

18.

Hasan A, Falkai P, Wobrock T, Lieberman J, Glenthoj B, Gattaz W . World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 2: update 2012 on the long-term treatment of schizophrenia and management of antipsychotic-induced side effects. World J Biol Psychiatry. 2012; 14(1):2-44. DOI: 10.3109/15622975.2012.739708. View

19.

Franz M, Fritz M, Gallhofer B, Meyer T . QLiS--development of a schizophrenia-specific quality-of-life scale. Health Qual Life Outcomes. 2012; 10:61. PMC: 3438130. DOI: 10.1186/1477-7525-10-61. View

20.

Kirschner M, Theodoridou A, Fusar-Poli P, Kaiser S, Jager M . Patients' and clinicians' attitude towards long-acting depot antipsychotics in subjects with a first episode of psychosis. Ther Adv Psychopharmacol. 2013; 3(2):89-99. PMC: 3805393. DOI: 10.1177/2045125312464106. View