Logo image
Back
The Use of Long-Acting Injectable Antipsychotics (LAI) in the Serious Mental Illness (SMI) Patients Enrolled in an Assertive Community Treatment (ACT) Program
Journal article   Open access   Peer reviewed

The Use of Long-Acting Injectable Antipsychotics (LAI) in the Serious Mental Illness (SMI) Patients Enrolled in an Assertive Community Treatment (ACT) Program

Maria Ruiza Yee, Eduardo Espiridon, Adeolu O Oladunjoye, Udema Millsaps, Anish Vora and Nailah Harvey
Curēus (Palo Alto, CA), v 13(4), pp e14490-e14490
14 Apr 2021
DOI: https://doi.org/10.7759/cureus.14490
PMID: 34007745
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.7759/cureus.14490View
Published, Version of Record (VoR)CC BY V4.0,  Open

Abstract

act lai Psychiatry Public Health serious mental illness
Introduction Patients with serious mental illness (SMI) experience highly intractable symptoms and great levels of dysfunction from their mental illness. Relapse prevention is critical as psychopathology, social and occupational functioning worsen with repeated psychotic episodes. Poor medication adherence is a strong predictor of relapse. Use of long-acting injectable antipsychotics (LAI) is among the most effective treatment specially in the context of non-adherence and yet remains underutilized. This single center retrospective study conducted using the electronic medical record (EMR) of patients enrolled in an Assertive Community Treatment (ACT) program at a community hospital was analyzed as to whether use of LAI among these patients reduce the frequency of emergency room visits and hospitalizations. Materials and methods Single center retrospective study using EMR of patients ages 20 and above who were enrolled at the ACT program at a community hospital from December 1, 2008 to December 31, 2018. Variables were collected from the EMR and de-identified into an Excel spreadsheet for data collation. Analysis was performed using SPSS software package. Results A total of 179 patients enrolled in the ACT program and their hospitalizations were extracted from the EMR. Seventy-six (42.5%) of these hospitalizations had patients on LAI. The hospitalizations were made up of 53.6% male, 81.9% White/Asian, 18.1% Black; 44.1% ages between 36 and 50 years old, 30.2% ages between 18 and 35 years old, and 25.7% greater than 50 years old. There was no difference in age, sex, race, ethnicity, insurance type and time spent in ACT program between those using LAI and those not on LAI. There was a higher proportion of psychiatric hospitalizations among LAI users compared with the non-LAI user group (57.9% vs 37.4%, p = 0.007). However, the two groups did not differ from one another in terms of psychiatric emergency visits (p = 0.266) or frequency of ACT visits (p = 0.062). Conclusion To date, all of the new-generation antipsychotic LAI have demonstrated a statistically and clinically significant decrease of relapse rates over placebo. Despite this, LAIs are not widely prescribed for a variety of reasons, including the reservations of patients, clinicians and payers. It would seem, though, that our patient population at the ACT program do not seem to benefit from use of LAI in relapse prevention. These results are counterintuitive in that one would expect that patients with serious mental illness would benefit from use of LAI. Perhaps, individuals with SMI are a different subset of population and they do not respond as well to LAI.

Metrics

10 Record Views
4 citations in Web of Science

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
Web of Science research areas
Psychiatry
Logo image