Neuropsychiatric Disease and Treatment (Mar 2023)
Changes in Clinical Management of Patients with Schizophrenia Treated with Long-Acting Injectable Antipsychotics (LAIs), Including Telepsychiatry Use, During the COVID-19 Pandemic
Abstract
Batool Haider,1 Amy K O’Sullivan,1 Leona Bessonova,1 Elizabeth Keane,1 Eric Achtyes,2 Philip D Harvey,3 John M Kane,4 Stephen R Saklad,5 Jeffrey P Trotter,6 Amy Claxton,1 Tiffany Polak,1 James McGrory,1 Wahidullah Noori,1 Asia Sikora Kessler,7 Aaron Yarlas,7 Dawn Velligan8 1Alkermes, Inc, Waltham, MA, USA; 2Cherry Health and the Michigan State University College of Human Medicine, Grand Rapids, MI, USA; 3University of Miami Miller School of Medicine, Miami, FL, USA; 4The Zucker Hillside Hospital, Glen Oaks, NY, USA; 5College of Pharmacy, University of Texas at Austin, Pharmacotherapy Division, San Antonio, TX, USA; 6Worldwide Clinical Trials, Research Triangle, NC, USA; 7QualityMetric Incorporated, LLC, Johnston, RI, USA; 8University of Texas Health Science Center at San Antonio, San Antonio, TX, USACorrespondence: Batool Haider, Alkermes, Inc, 852 Winter Street, Waltham, MA, 02451-1420, USA, Tel +1 781 609 6035, Email [email protected]: The COVID-19 pandemic substantially impacted care of patients with schizophrenia treated with long-acting injectable antipsychotics (LAIs). This study (OASIS-MAPS) examined how clinical sites adapted operations and used telepsychiatry to maintain standard of care for these patients during the pandemic.Methods: Two online surveys (initial: October–November 2020, N = 35; follow-up: July–September 2021, N = 21) were completed by a principal investigator (PI) or PI-appointed designee at sites participating in the OASIS study (NCT03919994). Survey responses were analyzed descriptively.Results: At the time of the initial survey, all 35 participating sites were using variants of telepsychiatry, with 20 sites adopting it after the pandemic started. Most sites reported no negative impacts of the pandemic on medication adherence, although approximately 20% of sites reported decreased adherence for LAIs. Twelve sites (34%) reported switching patients with schizophrenia from LAIs to oral antipsychotic medications, while 11 sites (31%) reported switching patients from shorter to longer injection interval LAIs during the pandemic. Most sites did not experience difficulties in implementing or expanding telepsychiatry services, although lower reimbursement rate for telepsychiatry and patients’ lack of access to and training on relevant technologies were the most frequently reported barriers.Conclusion: Changes made by sites after the pandemic onset were viewed by almost all participants as satisfactory for maintaining standard of care. Almost all participants thought that the use of telepsychiatry services would continue after the pandemic in a hybrid manner combining telepsychiatry and office visits. Ensuring that patients have equitable access to telepsychiatry will be important in the post-pandemic future.Keywords: telehealth, coronavirus, care management, medication adherence
