Changes in Clinical Management of Patients with Schizophrenia Treated with Long-Acting Injectable Antipsychotics (LAIs), Including Telepsychiatry Use, During the COVID-19 Pandemic.

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. 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. 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. 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.

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© 2023 Haider et al.

Déclaration de conflit d'intérêts

Batool Haider, James McGrory, and Elizabeth Keane are employees of Alkermes, Inc., a pharmaceutical company which manufactures products including antipsychotic medications for people with schizophrenia and bipolar I disorder. These authors may be shareholders. Amy K. O’Sullivan, Leona Bessonova, Amy Claxton, Tiffany Polak, and Wahidullah Noori were employees of Alkermes, Inc. at the time this study was conducted. Asia Sikora Kessler and Aaron Yarlas were employees of QualityMetric Incorporated, LLC, a consulting company specializing in health measurement solutions, which was paid by Alkermes, Inc. for assistance in study design, analyses, and manuscript development, at the time this study was conducted. Eric Achtyes has consulted or served on advisory boards for Alkermes Inc., and has received research grants and/personal fees from Alkermes, Inc, Biogen, Boehringer Ingelheim, Janssen, Neurocrine Biosciences, Takeda, Atheneum, Karuna, Lundbeck, Otsuka, Sunovion, Teva; briefly owned stock from AstraZeneca, Johnson and Johnson, Moderna, and Pfizer, outside the submitted work. Philip D. Harvey, John M. Kane, Stephen R. Saklad, and Dawn Velligan have served as paid consultants for Alkermes, Inc. Philip D. Harvey reports personal fees from Bioexcel, Boehringer Ingelheim, Karuna Pharma, Merck Pharma, Minerva Pharma, Roche Pharma, Sunovion Pharma, principal investigator for iFunction, royalties from WCG Verasci, payment for grant reviews from Alkermes, outside the submitted work. John M. Kane reports personal fees from Alkermes, Allergan, Boehringer Ingelheim, Indivior, Intracellular Therapies, Johnson & Johnson, Merck, Minerva, Neurocrine, HLS, HealthRhythms; personal fees from and shareholder of LB Pharmaceuticals, Vanguard Research Group, North Shore Therapeutics; grants and personal fees from Janssen Pharmaceutical, Sunovion; personal fees from and advisory board of Newron, Novartis, Otsuka, Teva, Click Therapeutics, Cerevel, Dainippon Sumitomo, H. Lundbeck; royalties from UpToDate, outside the submitted work. Dawn Velligan reports grants and/or personal fees from Alkermes, Indivior, Otsuka, Karuna, and Janssen, during the conduct of the study. Jeffrey Trotter is an employee of Worldwide Clinical Trials, a clinical research vendor paid by Alkermes, Inc. The authors report no other conflicts of interest in this work.