Neuropsychiatric Disease and Treatment (Apr 2019)
The modern perspective for long-acting injectables antipsychotics in the patient-centered care of schizophrenia
Abstract
Francesco Pietrini,1 Umberto Albert,2 Andrea Ballerini,3 Paola Calò,4 Giuseppe Maina,5 Federica Pinna,6 Marco Vaggi,7 Ileana Boggian,8 Maria Fontana,4 Cesare Moro,9 Bernardo Carpiniello10,61Department of Mental Health and Addictions, Central Tuscany NHS Trust, Florence, Italy; 2Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy; 3Department of Health Sciences, Florence University School of Medicine, Florence, Italy; 4Department of Mental Health, Azienda Sanitaria Locale Lecce, Lecce, Italy; 5Rita Levi Montalcini Department of Neuroscience, University of Torino, Torino, Italy; 6Department of Medical Sciences and Public Health, Unit of Psychiatry, University of Cagliari, Cagliari, Italy; 7Department of Mental Health and Drug Addiction ASL 3 Genoa, Azienda Sanitaria 3 Genovese, Genoa, Italy; 8Department of Mental Health, Azienda Ulss 9 Scaligera, Legnago, Italy; 9Department of Mental Health and Addictions, ASST Bergamo Ovest, Treviglio, Italy; 10Psychiatric Clinical Unit, University Hospital of Cagliari, Cagliari, ItalyAbstract: Schizophrenia is a chronic syndrome involving different clinical dimensions, and causes significant disability with a negative impact on the quality of life of patients and their caregivers. Current guidelines for the treatment of schizophrenia focus on maximizing a patient’s adaptive functioning and quality of life in a recovery-oriented approach that encourages active collaboration among patients, caregivers, and mental health professionals to design and manage a customized and comprehensive care plan. In the present study, a panel of experts (psychiatrists, psychologists, nurse, and social worker) gathered to review and explore the need for contemporary use of second-generation antipsychotic long-acting injectables (SGA LAIs) in “recovery-oriented” and “patient-centered” care of schizophrenia. Starting from the available data and from sharing personal attitudes and experiences, the panel selected three clinical dimensions considered useful in characterizing each patient: phase of disease, adherence to treatment, and level of functioning. For each clinical dimension, perspectives of patients and caregivers with regard to needs, expectations, and personal experiences were reviewed and the role of SGA LAIs in achieving shared goals examined. The experts concluded that from today’s modern perspectives, SGA-LAIs may play an important role in breaking the spiral of desocialization and functional decline in schizophrenia, thus favoring the recovery process.Keywords: long-acting injections, antipsychotic, schizophrenia, quality of life, subjective well-being, recovery
