Perception and willingness toward second-generation long-acting antipsychotics among patients with schizophrenia: a...

To assess perceptions and willingness toward second-generation antipsychotic long-acting injectables (SGA-LAIs) among patients with schizophrenia, to identify the influencing factors, and to provide evidence for optimizing clinical implementation strategies.

A cross-sectional survey was conducted in which patients with schizophrenia who attended outpatient follow-up visits at a tertiary psychiatric hospital were recruited via convenience sampling. A validated, expert-reviewed questionnaire was administered. Data were analyzed using descriptive statistics and chi-square tests, with binary logistic regression models employed to explore the determinants of patients' willingness to accept SGA-LAIs.

The sample characteristics included 126 males (55.5%), 114 patients (50.2%) aged 31-50 years, 140 patients (61.7%) with an illness course exceeding 5 years, and 126 patients (55.5%) with experience with SGA-LAIs. Overall, 155 participants (68.3%) expressed positive willingness to use SGA-LAIs, whereas 72 participants (31.7%) expressed negative willingness. Univariate analysis revealed significant differences between the willingness-positive and willingness-negative groups in terms of disease course (χ² = 12.314, P = 0.006) and prior SGA-LAI experience (χ² = 55.525, P < 0.001). Binary logistic regression analysis revealed that patients with prior SGA-LAI experience (OR = 11.11, 95% CI: 5.41~23.26, P < 0.001), a disease course of 5-10 years (OR = 2.898, 95% CI: 1.134-7.407, P = 0.026), and a disease course of > 10 years (OR = 3.282, 95% CI: 1.300-8.288, P = 0.012) demonstrated significantly greater willingness to accept SGA-LAIs. Among the willingness-positive group, the most endorsed advantages of SGA-LAIs were "avoiding daily medication" (80.7%) and "increased effectiveness" (68.4%), and the primary concern was "injection pain" (56.8%). In the willingness-negative group, the predominant reasons for refusal were "rejection of needles" (93.1%) and "rejection of changing therapeutic regimens" (79.2%).

The overall acceptance of and willingness to use SGA-LAIs among patients with schizophrenia followed up in psychiatric hospitals are high. Experience with SGA-LAIs and disease course were identified as independent factors influencing patients' willingness to use SGA-LAIs. In clinical practice, patient acceptance can be enhanced by strengthening doctor-patient communication, prioritizing medication education for patients with a long disease course, and improving patients' initial experience with SGA-LAIs, thereby supporting broader clinical adoption of SGA-LAIs.