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Prevalence and Impact of Relapse in Patients With Schizophrenia
What can you do to combat relapse in your patients with schizophrenia? Dr Lauriello discusses identifying and addressing nonadherence to antipsychotics.
Abstract
Many individuals with schizophrenia experience multiple relapses, which are associated with serious and potentially fatal outcomes. Nonadherence to antipsychotic medications is a major contributor to relapse. By using reliable strategies to measure adherence and identify patients who are not taking their medications as prescribed, clinicians can intervene to possibly prevent relapse or decrease its severity.
From the Series: The Schizophrenia Remission Roller Coaster: Using Long-Acting Injectable Antipsychotics to Improve Adherence and Enhance Potential for Functional Recovery
To cite: Lauriello J. Prevalence and impact of relapse in patients with schizophrenia. J Clin Psychiatry. 2020;81(1):MS19053BR1C.
To share: https://doi.org/10.4088/JCP.MS19053BR1C
© Copyright 2020 Physicians Postgraduate Press, Inc.
Target Audience
- Psychiatrists
- Nurse practitioners
- Physician assistants
Learning Objectives
After completing this educational activity, you should be able to:
- Identify patients who may benefit from LAI antipsychotic treatments
Support Statement
Supported by an educational grant from Alkermes, Inc.; Otsuka America Pharmaceutical, Inc. and Lundbeck.
Learning Objective
- Identify patients who may benefit from LAI antipsychotic treatments
Release, Review, and Expiration Dates
This brief report activity was published in March 2020 and is eligible for AMA PRA Category 1 Credit™ through March 31, 2022. The latest review of this material was January 2020.
Statement of Need and Purpose
The goals of schizophrenia treatment are to control symptoms, prevent relapse, and improve functioning and quality of life. For many patients, these goals are not being met. Evidence demonstrates that LAI antipsychotics are one of the most effective ways to prevent relapse in patients with schizophrenia, yet they remain underused. Health care providers infrequently discuss LAI antipsychotic options with their patients with schizophrenia. Clinicians also may overestimate adherence or not even assess it despite guideline recommendations. Patients with multiple relapses are often continued on oral medications, and few clinicians consider LAIs early in the course of illness. Health care providers need education on the efficacy, safety, and dosage/administration of LAIs, as well as on discussing LAIs with their patients.
Disclosure of Off-Label Usage
Dr Lauriello has determined that, to the best of his knowledge, no investigational information about pharmaceutical agents that is outside US Food and Drug Administration–approved labeling has been presented in this article.
Review Process
The faculty members agreed to provide a balanced and evidence-based presentation and discussed the topics and CME objectives during the planning sessions. The faculty’s submitted content was validated by CME Institute staff, and the activity was evaluated for accuracy, use of evidence, and fair balance by a peer reviewer who is without conflict of interest.
Acknowledgment
This activity is derived from the teleconference series “The Schizophrenia Remission Roller Coaster: using Long-Acting Injectable Antipsychotics to Improve Adherence and Enhance Potential for Functional Recovery,” which was held in September and October 2019 and supported by educational grants from Alkermes, Inc.; Otsuka America Pharmaceutical, Inc. and Lundbeck.
Faculty Affiliation
John Lauriello, MD
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
Financial Disclosure
The faculty for this CME activity and the CME Institute staff were asked to complete a statement regarding all relevant personal and financial relationships between themselves or their spouse/partner and any commercial interest. The Accreditation Council for Continuing Medical Education (ACCME) defines a commercial interest as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The ACCME defines relevant financial relationships as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. The CME Institute has resolved any conflicts of interest that were identified. No member of the CME Institute staff reported any relevant personal financial relationships. Faculty financial disclosure is as follows:
Dr Lauriello is a consultant for Indivior and Alkermes and a member of the speakers/advisory board for Roche.
The Chair, Christoph U. Correll, MD, is a consultant for and has received honoraria from Acadia, Alkermes, Allergan, Angelini, Axsome, Boehringer-Ingelheim, Gedeon Richter, Gerson Lehrman Group, Indivior, IntraCellular Therapies, Janssen, LB Pharma, Lundbeck, MedAvante-ProPhase, Medscape, Merck, Neurocrine, Noven, Otsuka, Pfizer, Recordati, ROVI, Servier, Sumitomo Dainippon, Sunovion, Supernus, Takeda, and Teva; has received grant/research support from Janssen and Takeda; is a member of the speakers/advisory boards for Alkermes, Allergan, Angelini, Gedeon Richter, IntraCellular Therapies, Janssen, LB Pharma, Lundbeck, Neurocrine, Noven, Otsuka, Pfizer, Recordati, Sumitomo Dainippon, Sunovion, Supernus, Takeda, and Teva; is a stock option shareholder of LB Pharma; and has received other financial or material support for expert testimony from Bristol-Myers Squibb, Janssen, and Otsuka and royalties from UpToDate.
Accreditation Statement
The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Credit Designation
The CME Institute of Physicians Postgraduate Press, Inc., designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.
To obtain credit for this activity, study the material and complete the CME Posttest and Evaluation.
MOC Approval Statement
Through the American Board of Medical Specialties (“ABMS”) ongoing commitment to increase access to practice relevant Continuing Certification Activities through the ABMS Continuing Certification Directory, Prevalence and Impact of Relapse in Patients With Schizophrenia has met the requirements as a MOC Part II CME Activity (apply toward general CME requirement) for the following ABMS Member Boards:
MOC Part II CME Activity
Psychiatry and Neurology
Available Credit
- 0.50 AMA PRA Category 1 Credit™
- 0.50 Participation