Factors associated with rates of long-acting injectable antipsychotic use for schizophrenia: A subgroup analysis of the multinational ADVANCE study.

INTRODUCTION: Long-acting injectable antipsychotics (LAIs) are underused despite known benefits. This subgroup analysis from the Attitudes DriVing regional differences in LAI ANtipsychotic utilization for schizophrenia among healthcare professionals (HCPs), patients, and CaregivErs (ADVANCE) study aimed to understand factors influencing high versus low use of LAIs by HCPs. METHODS: HCPs in ADVANCE included psychiatrists and psychiatric non-physicians from Australia, Canada, China, Germany, Israel, South Korea, Spain, and the United States who reported treating patients with schizophrenia. HCPs were stratified into high (>40 %) and low (≤20 %) LAI use groups based on self-reported proportion of patients with schizophrenia in their practice taking antipsychotics using LAIs. RESULTS: High LAI users (n = 186) reported managing more patients with schizophrenia/month (mean: 66.2 vs 36.6, p < .0001), prescribing antipsychotics to more patients with schizophrenia per month (mean: 68.8 vs 34.3, p < .0001), having more support staff (mean: 14.3 vs 10.4, p < .0001), and spending more time with patients in appointments (initial, 50.6 vs 43.1 min, p < .0001; follow-up, 26.8 vs 22.8 min, p < .0001) than low LAI users (n = 350). High LAI users recommended LAIs to more of their patients with schizophrenia (73.3 %vs 32.7 %, p %, P < .0001), were more confident talking about LAIs, and were more likely to recommend LAIs to patients who were nonadherent or experiencing first-episode psychosis or acute exacerbations than low LAI users (all p < .05). Low LAI users reported more access issues and barriers to LAI use than high LAI users. CONCLUSION: Targeted education and practical guidance for high and low LAI users may help reduce barriers to LAI use.