BackgroundPatient preferences in schizophrenia (SCZ), including identification of key goals and outcomes for treatment and relative importance of certain treatment goals to patients, have been assessed by several studies. However, there continues to be a lack of sufficient evidence on US patient attitudes and perceptions towards treatment goals and pharmacotherapy options in SCZ, especially taking into context long-acting injectable antipsychotics (LAIs) in this disease area. This lack of evidence is further pronounced in caregivers of individuals with SCZ. The objective of this analysis was to characterize patients with SCZ on LAIs vs patients on oral antipsychotics (OAPs) and evaluate the treatment goals of patients in each group.MethodsThis was a real-world, cross-sectional survey of US psychiatrists, patients =18 years old with a diagnosis of SCZ, and caregivers. Data was collected using the Disease Specific Programme (DSP) methodology, which has been previously published. Psychiatrists (n=120) completed detailed record forms for next 8 consecutive outpatients and 2 inpatients matching inclusion criteria, including non-interventional clinical and subjective assessments. The same patients and their caregivers, if present, were invited by their psychiatrist to voluntarily complete a separate survey.ResultsOf 1135 patients on treatment where the physician provided survey data; 251 were on an LAI, and 884 were on an OAP. Mean (SD) time to SCZ diagnosis for those on an LAI was 10.3 (12.0) years vs 7.8 (10.5) years for those on OAPs. More patients in the LAI vs OAP group were being treated as an inpatient (27.1% vs 15.7%, respectively; p<0.0001). Patients on an LAI reported being on their current medication regimen for less time (mean 1.7 years) vs those on OAPs (mean 2.5 years) (p=0.0093). More patients on LAIs were unemployed due to disability vs those on OAPs (56.1% vs 39.5%, respectively), and less patients on LAIs were able to work part-time or full-time (21.1% or 4.1%) vs those on OAPs (23.2% or 11.4%). More patients on an LAI had a caregiver vs those on OAPs (37.3% vs 26.1%, respectively; p=0.0011). Regarding the most important treatment goals reported by patients, both groups reported similar preferences for decrease in disease symptoms (62% on LAI vs 65% on OAPs) and thinking more clearly (53% on LAI vs 46% on OAPs); however, a numerically higher proportion of LAI patients reported that the current medication helped decrease hospitalizations due to relapse vs those on OAPs (38% vs 32%, respectively).DiscussionGiven the characteristics of patients participating in this real-world survey, those on LAIs exhibited qualities which indicate a higher severity of illness vs those on OAPs. Results suggest that treatment with LAIs is still mainly being provided to patients later in the disease course and/or who have adherence problems, despite a growing body of evidence of utility in younger patients earlier in the course of illness.FundingOtsuka Pharmaceutical Development & Commercialization, Inc. and Lundbeck LLC

中文翻译：

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长效注射剂与口服抗精神病药患者的特征和治疗目标：患者/护理人员/精神病医生调查结果

背景患者对精神分裂症 (SCZ) 的偏好，包括确定治疗的关键目标和结果以及某些治疗目标对患者的相对重要性，已通过几项研究进行了评估。然而，仍然缺乏足够的证据表明美国患者对 SCZ 治疗目标和药物治疗选择的态度和看法，特别是考虑到该疾病领域的长效注射用抗精神病药物 (LAIs)。这种缺乏证据的情况在 SCZ 患者的护理人员中更加明显。该分析的目的是描述使用 LAI 的 SCZ 患者与使用口服抗精神病药物 (OAP) 的患者的特征，并评估每组患者的治疗目标。被诊断为 SCZ 的患者 = 18 岁，以及护理人员。使用先前发表的疾病特定计划 (DSP) 方法收集数据。精神科医生 (n=120) 填写了符合纳入标准的接下来 8 名连续门诊患者和 2 名住院患者的详细记录表，包括非干预性临床和主观评估。相同的患者及其护理人员（如果在场）由他们的精神科医生邀请自愿完成一项单独的调查。结果 医生提供调查数据的 1135 名接受治疗的患者；251 个使用 LAI，884 个使用 OAP。LAI 患者诊断 SCZ 的平均 (SD) 时间为 10.3 (12.0) 年，而 OAP 患者为 7.8 (10.5) 年。LAI 组与 OAP 组中有更多的患者接受住院治疗（分别为 27.1% 和 15.7%；p<0.0001）。与使用 OAP 的患者（平均 2.5 年）相比，接受 LAI 的患者报告他们目前的药物治疗时间（平均 1.7 年）更短（p=0.0093）。与使用 OAP 的患者相比，使用 LAI 的更多患者因残疾而失业（分别为 56.1% 和 39.5%），与使用 OAP 的患者相比，使用 LAI 的患者能够兼职或全职工作的患者更少（21.1% 或 4.1%） （23.2% 或 11.4%）。与使用 OAP 的患者相比，更多使用 LAI 的患者有看护人（分别为 37.3% 和 26.1%；p=0.0011）。关于患者报告的最重要的治疗目标，两组都报告了相似的减轻疾病症状的偏好（LAI 为 62%，OAP 为 65%）和思维更清晰（LAI 为 53%，OAP 为 46%）；然而，较高比例的 LAI 患者报告说，与使用 OAP 的患者相比，目前的药物有助于减少因复发而住院的人数（分别为 38% 和 32%）。讨论鉴于参与这项真实世界调查的患者的特征，使用 LAI 的患者表现出品质这表明与 OAP 相比，疾病的严重程度更高。结果表明，尽管越来越多的证据表明在病程早期对年轻患者有用，但 LAI 治疗仍主要提供给病程后期和/或有依从性问题的患者。资金大冢制药开发和商业化，公司和灵北有限责任公司 与 OAP 相比，使用 LAI 的人表现出的疾病严重程度更高。结果表明，尽管越来越多的证据表明在病程早期对年轻患者有用，但 LAI 治疗仍主要提供给病程后期和/或有依从性问题的患者。资金大冢制药开发和商业化，公司和灵北有限责任公司 与 OAP 相比，使用 LAI 的人表现出的疾病严重程度更高。结果表明，尽管越来越多的证据表明在病程早期对年轻患者有用，但 LAI 治疗仍主要提供给病程后期和/或有依从性问题的患者。资金大冢制药开发和商业化，公司和灵北有限责任公司