A Comparative Study of Antipsychotic Drugs Use Among Psychiatric Patients in Palestine Quality of Life (QOL) and Long-acting Injectable (LAI) Assessment
Al-Quds University, Deanship of Scientific Research
past decade and were used mainly for long-term treatment of schizophrenia. However, their role in short term intermittent use and for other psychiatric conditions were not elucidated clearly. Objectives: To compare the quality-of-life improvement for patients on LAIs comparing to conventional treatment and whether the improvement was clinical or psychosocial in nature. Methods: A retrospective cohort study was run on psychiatric patients who are taking LAIs and/or conventional treatment at Mohammad Said Kamal hospital for mental illness in Bethlehem and Mental Health Clinic of The Ministry of Health in Hebron city from September 2019 to March 2020. GAF score was calculated for each patient among other mental scale scores such as CGI-S and DIEPSS to determine the quality of life and other aspects of improvement. Patients were categorized into LAIs-taking only or LAIs and conventional treatment groups. A previously used and standardized questionnaire with some modifications was used to collect information about relapse and enhancement of their status. Results: Fifty-one patients were included in this study, 74 % were males, age 30-89 years old (42% were 50-59 years old). Ten percent of patients only were on LAIs alone and the rest were taking a combination of both LAIs and conventional treatment. Patients' GAF scores ranged from 11-20 to 91-100 with a spectrum of patients on all GAF score scale range. Thirty-seven percent of patients fell in the GAF score 51-60; Moderate symptoms (flat affect and circumlocutory speech, occasional panic attacks) or moderate difficulty in social, occupational, or school functioning. Patients were taking one to six drugs at a time. There was a negative relationship between taking many drugs along with LAIs and scoring badly on GAF scale. One patient was on Haloperidol IM depot injection scored 91-100 on GAF and was stable and improving. The main reasons for substitution to LAIs from highest to lowest, were as follows; adherence (24 patients), no reason at all (14), patient dissatisfaction (7), adherence and patient dissatisfaction (3), then side effects, convenience (ease of use), and availability of the drug at the same level (1 patient each). Conclusions: Erratic drug supply especially during crises times (COVID-19) for crucial drugs such as LAIs plays a major role in adherence and prognosis of psychiatric conditions. Dealing with LAIs as emergency use only in some practices was the main reason for relapse and instability in psychiatric conditions and will affect social improvement.
LAIs , conventional antipsychotic therapy , adherence , GAF score , Quality of life , psychosocial improvement