Barriers to Long-acting Injectable Antipsychotic Adherence During the COVID-19 Pandemic: Observations From One Site

Area of Science:

• Psychiatry
• Public Health
• Health Services Research

Background:

• Long-acting injectable antipsychotics (LAI-As) are vital for managing serious mental illness.
• Pandemics present unique challenges to the continuity of care for LAI-A recipients due to in-person administration requirements.

Purpose of the Study:

• To investigate the impact of the COVID-19 pandemic on LAI-A adherence.
• To examine changes in LAI-A prescribing and administration practices during the pandemic.
• To identify pandemic-related barriers to LAI-A adherence.

Main Methods:

• Evaluation of electronic health records for 101 patients prescribed LAI-As.
• Interviews with 13 patients to assess subjective concerns about pandemic-related adherence barriers.

Main Results:

• Pandemic-related barriers or medication changes affected 33% of patients.
• A higher incidence of missed or delayed LAI-A doses was observed during the pandemic compared to before.
• Only 2 of 13 interviewed patients anticipated pandemic-related interference with adherence.

Conclusions:

• Pandemics can disrupt LAI-A access and adherence, though findings may not generalize to all sites.
• Psychiatric providers should proactively address potential access barriers, as patients may not anticipate disruptions.
• Enhanced preparedness and safeguards are needed to mitigate adverse outcomes from pandemic-related disruptions to LAI-A access and adherence.