Margaret Harvey, PhD, APRN, ACNP-BC, CHFN
Purpose/Background Medication adherence is a major issue for patients suffering from schizophrenia and medication non-adherence can lead to psychiatric morbidity. Although long-acting injectable (LAI) antipsychotics have been shown to improve treatment adherence, most clinicians continue to rely on oral therapies to manage schizophrenia. This scoping review will assess evidence-based literature to determine the relationship between the use of LAIs and medication adherence in patients with schizophrenia.
Methods A literature review was conducted between August 2020 and January 2021 to find studies that have evaluated medication adherence with the use of long-acting injectables in patients with schizophrenia. Relevant literature initially selected was analyzed by a rapid critical appraisal (RCA). Ten articles ranging from the years 2005 to 2019 were selected to be in the scoping review. A synthesis and outcomes table was developed to examine the level of evidence for each article, assess the variables measured in each study, and track the outcome of each variable.
Results The data collection consisted of 10 articles with varying levels of evidence: a meta-analysis, randomized control trials, controlled trials without randomization, cohort studies, and a literature review. All articles addressed the effect of long-acting injectables on treatment adherence. The principal variable addressed was treatment adherence, but additional variables include reduced hospitalizations and reduced relapse rate. All studies in this scoping review confirm the advantages of long-acting injectables in quality patient outcomes.
Implications for Nursing Practice The studies examined support long-acting injectables to enhance treatment adherence, but there is not an abundance of evidence to suggest a practice or protocol change. More research is required in larger sample sizes and real-life settings to generalize to the general population.
Holton, Britney Michelle MSN, FNP-BC; Jones-Purdy, Patricia Rena MSN, CNRN; and Harvey, Margaret PhD, APRN, ACNP-BC, CHFN , "Evaluating the Use of Long-Acting Injectables as a Method to Improve Treatment Adherence in Patients with Schizophrenia: A Scoping Review" (2022). Doctor of Nursing Practice Projects. Paper 31. http://dx.doi.org/10.21007/con.dnp.2022.0031.
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