Prescribing patterns of long acting injectable antipsychotics at community psychiatric clinics in Johannesburg

Abstract

Although long-acting injectable antipsychotics (LAI-APs) improve adherence and reduce the risk of relapse in schizophrenia, they are prescribed late, after functional deterioration has occurred. There is a paucity of information regarding prescribing practices for LAI-APs in South Africa. A retrospective review of the charts of 206 patients on LAI-APs attending three psychiatric clinics in Johannesburg was conducted. Significantly more patients were male (74.8%), single (94.2%) and, unemployed or in receipt of a social grant (96.1%) (p<0.001). A comorbid substance use disorder was diagnosed in 47.6%, and the indication for the prescription of a LAI-AP was non-adherence in 66.0%. In 90.3% of the patients, some other psychotropic medication was prescribed in combination with the LAI –AP. This study confirms a missed opportunity in that LAI-APs were prescribed after patients were non–compliant with oral antipsychotics. We highlight the high prevalence and problem of LAI -AP polypharmacy