Experiences and perceptions of patients, caregivers, and healthcare professionals with long-acting injectable antipsychotics for the treatment of schizophrenia: qualitative results from the multinational ADVANCE study
Bibliographic record
Abstract
Introduction: Schizophrenia imposes a substantial burden on individuals and society. Long-acting injectable antipsychotics (LAIs) improve adherence and reduce relapse and hospitalization rates compared with oral treatments for schizophrenia, yet LAI use varies globally. The qualitative interview portion of the global Attitudes DriVing regional differences in long-acting injectable ANtipsychotic utilization for schizophrenia among healthcare professionals (HCPs), patients, and CaregivErs (ADVANCE) study explored the patient journey from schizophrenia diagnosis to treatment, treatment goals, and experiences and perspectives on LAIs that may influence their use. Methods: 65% of their time providing direct patient care, managed an adult population of whom ≥10% have schizophrenia, and treated patients with second-generation LAIs. Patients with schizophrenia aged ≥18 years and caregivers of individuals living with schizophrenia who had experience with LAIs were eligible. Participants completed a 60-minute, semi-structured telephone interview. Results: Seventeen HCPs, 20 patients, and 19 caregivers completed interviews. HCPs reported that patients often follow a cycle of treatment and relapse, with inpatient care focused on acute symptoms management, while outpatient treatment was more likely to prioritize long-term quality of life. The most common HCP-reported barriers to LAI use were patient aversion to injections, logistical challenges, and patient trauma from prior forced injection. Two distinct treatment/disease management pathways emerged from patient interviews: 1) treatment early in symptom development with strong outpatient support, and 2) severe, acute episodes that required hospitalization. Patients initially treated in an outpatient setting were likely to accept LAIs, while those treated in inpatient settings often feared treatment, felt a lack of control, and were less likely to accept an LAI for long-term care. Caregivers had roles in disease management and focused more on patient quality of life rather than treatment management. Conclusions: Interactions between patients with schizophrenia and psychiatrists or psychiatric nurses vary depending on the care setting, which can influence the acceptance of LAIs. Initial schizophrenia presentation, family support, hospitalizations, trust in HCPs, and logistical challenges may all play a role in patient outcomes and perceptions of LAIs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.018 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.006 | 0.005 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".