Explicit review of risperidone long-acting injection prescribing practice.

Area of Science:

• Psychiatry
• Pharmacology
• Clinical Practice

Background:

• Long-acting injectable (LAI) antipsychotics are recommended for specific patient groups, offering improved outcomes and adherence compared to oral medications.
• Risperidone long-acting injection (RLAI) is an effective and well-tolerated LAI antipsychotic used in clinical trials.
• Understanding real-world prescribing practices for RLAI is crucial for optimizing patient care.

Purpose of the Study:

• To review risperidone long-acting injection (RLAI) prescribing practices in New Zealand.
• To compare RLAI prescribing against established best practice recommendations.
• To identify any deviations from recommended guidelines in clinical settings.

Main Methods:

• Retrospective data collection from 443 patients initiating publicly funded RLAI between October 2005 and October 2006.
• Data gathered at seven time-points, spanning 1 year before and 1 year after RLAI initiation.
• Analysis included patient characteristics, diagnoses, treatment history, and antipsychotic co-prescribing patterns.

Main Results:

• Most patients had schizophrenia or related psychoses, adherence issues, and prior oral risperidone use.
• RLAI initiation and initial dosing (25 mg/2 weeks) largely followed recommendations, with significant treatment crossover.
• Mean fortnightly doses increased over 12 months, remaining within the licensed range; however, high rates of antipsychotic co-prescribing were observed.

Conclusions:

• RLAI prescribing in New Zealand generally aligns with best practice recommendations.
• High rates of antipsychotic co-prescribing with RLAI represent a deviation from recommended practice and require further evaluation.
• Clinical audit is effective in identifying prescribing variations, highlighting the need for feedback and re-audit to improve practice.