Naturalistic Observational Study of Patients Receiving Risperidone Long-acting Injection (RLAI)

Abstract

Background:

Risperidone is the first atypical antipsychotic available in a long-acting injection formulation. in United Kingdom, it is licensed for use in treatment of psychosis in patients tolerant of oral Risperidone. the Summary of Product Characteristics clearly defines the methods of initiation and titration.

Methods:

We performed a naturalistic observational study of 61 patients suffering with psychosis. the cohort comprised patients being prescribed Risperidone long-acting Injection (RLAI) within various Community Mental Health Teams and Assertive Outreach Team of the Trust. the data was collected related to three broad areas: reasons for choice of RLAI, initiation and titration of RLAI, continuation of RLAI.

Results:

• • 35/61 patients have been prescribed oral atypical antipsychotic (including 16/61 being prescribed oral Risperidone) prior to the injectable formulation and 3/61 had received Clozapine.

• • In 12/61 non-compliance was suspected and only 11/25 patients stated a preference for an injectable formulation.

• • 33/61 received oral supplementation during initiation.

• • 29/61 were initiated on dose of RLAI commensurate with the current dose of oral Risperidone

• • In 35/61, dose was changed in less than 4 weeks intervals.

• • 43/61 continued to receive RLAI. 18/61 discontinued due to patient refusal (6/18), patient not tolerated (3/18), not effective (2/18), patient non-attendance (1/18), patient moved area (1/18), other reasons (2/18), no reasons specified (3/18).

Conclusions:

Prescribing of RLAI did not follow recommendation from manufacturers during initiation and titration. Non-Compliance with previous medication was main reason for use of RLAI. However, discontinuation with RLAI was primarily related to refusal/intolerance of treatment.