Determining what practising clinicians believe about long-acting injectable antipsychotic medication

Abstract

Objective. To explore the factors that influence clinician prescribing choice when using depot anti-psychotics. Methods. A two-phase qualitative exploration of the attitudes to and knowledge about risperidone long-acting injection (RLAI) in a group of New Zealand psychiatrists. The first phase was conducted shortly after the treatment was funded (n = 16), the second phase was a year or so later (n = 35). Data was gathered using a focus group technique with scenario stimulus. The data were examined using thematic analysis. Results. Themes fitted the broad categories of who RLAI was used for, how it was best used, what were the efficacy determinants and what adverse effect monitoring occurred. For many areas of exploration there was a gap between actual practice and what the psychiatrist thought might be best practice. There was considerable variance in details regarding the administration of the treatment including dose, titration and efficacy monitoring. Conclusions. The results confirm the utility of quantitative exploration in understanding prescribing choice. The effect of outdated views regarding long-acting injectable (LAI) antipsychotics contributes to a gap between actual practice and what is thought to be desirable. The study targeted RLAI but findings are likely to also pertain to other LAI anti-psychotics.