Impact of COVID-19 Pandemic on Prescribing of Long-Acting Injectable Antipsychotics for Schizophrenia: Results from a United States Prescriber Survey

Abstract

Purpose

To describe changes due to the COVID-19 pandemic in the prescribing of long-acting antipsychotics (LAI) for schizophrenia, patient outcomes, and patient and healthcare provider (HCP) attitudes regarding COVID-19 vaccination in the United States (US).

Methods

An anonymous online survey was administered to US-based LAI prescribers with a psychiatry specialty in May 2021. Information on prescriber and clinical practice characteristics, LAI prescribing, patient outcomes, and attitudes toward COVID-19 vaccination was collected and described.

Results

Of the 401 LAI prescribers meeting survey criteria, 64.6% reported that LAI prescribing remained unchanged (increase: 19.2%, decrease: 14.0%). The majority did not switch patients from LAIs to oral antipsychotics (OAP; 63.3%) or to LAI formulations with lower frequency of administration (68.1%); most prescribers switched the same number of patients from OAPs to LAIs during the pandemic as in previous practice (65.1%). Half of LAI prescribers (50.1%) reported antipsychotic adherence as unchanged among most patients; 44.6% reported symptom control/relapse frequency as unchanged. Most prescribers believed their patients with schizophrenia should be prioritized for COVID-19 vaccination (74.1%) and encouraged all patients to obtain a COVID-19 vaccine (84.0%). However, 64.1% of prescribers reported hesitancy among some patients about vaccines’ safety; 51.4% reported that some patients were willing to be vaccinated despite the hesitancy, 48.6% indicated that some patients perceived COVID-19 vaccines as safe, effective, and important.

Conclusion

LAI prescribing and prescriber-reported antipsychotic adherence in patients with schizophrenia remained largely unchanged approximately one year after the start of COVID-19. Focused efforts to overcome patients’ COVID-19 vaccine hesitancy are warranted.

Keywords:

• adherence
• antipsychotics
• COVID-19
• physician survey
• prescribing habits
• schizophrenia

Abbreviations

APA, American Psychiatric Association; COVID-19, coronavirus disease of 2019; HCP, healthcare provider; LAI, long-acting injectable antipsychotics; OAP, oral antipsychotics; US, United States.

Data Sharing Statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data are not available. Therefore, restrictions apply to the availability of these data, which are not publicly available.

Ethics Approval and Informed Consent

Study participants provided their informed consent prior to responding to the survey questions. All study materials were reviewed by the WIRB-Copernicus Group Independent Review Board, and the study was granted an exemption determination per Title 45 of CFR, Part 46.104(d)(2) as no personally identifiable information was collected.

Acknowledgments

The authors thank the prescribers who participated in this survey. We acknowledge Shelley Batts, PhD, of Analysis Group, Inc. for medical writing assistance, which was funded by Janssen Scientific Affairs, LLC. We also acknowledge Camilo Obando, MD, MBA, an employee of Janssen Scientific Affairs, LLC, and Sophia Monaghan, MS, an employee of Janssen Scientific Affairs, LLC during the study’s conduct, for support in study design and results interpretation.

Author Contributions

All authors have made significant contributions to the conception or design of the study, or the acquisition, analysis, or interpretation of data, drafting the manuscript and revising it critically for important intellectual content, have provided final approval of this version to be published, and agree to be accountable for all aspects of the work.

Disclosure

Maryia Zhdanava, Todor I. Totev, Patrick Lefebvre, Aditi Shah, Kristy Sheng, and Dominic Pilon are employees of Analysis Group, Inc., which provided consulting services to Janssen Scientific Affairs, LLC for the conduct of this study. H. Lynn Starr was an employee of Janssen Scientific Affairs, LLC and held stock in Johnson & Johnson, Inc. (the parent company of Janssen) during the conduct of this study.

Additional information

Funding

This work was supported by Janssen Scientific Affairs, LLC.