| Summary: | Katarina Kelin1, Alan JM Brnabic2, Richard Newton3, Raúl I Escamilla4, Liang-Jen Chuo5, Malina Simu6, Wenyu Ye2, William Montgomery1, Jamie Karagianis7, Haya Ascher-Svanum81Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia; 2Intercontinental Information Sciences, Eli Lilly Australia Pty Ltd, Macquarie Park, NSW, Australia; 3Peninsula Health Psychiatric Services, Frankston Hospital, Frankston, VIC, Australia (current affiliation: Department of Psychiatry, Austin Hospital, Heidelberg, VIC, Australia); 4Schizophrenia Clinic, National Institute of Psychiatry, Mexico City, México D.F; 5Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan; 6St Stelian Hospital, Bucharest, Romania; 7Eli Lilly Canada Inc., Toronto, ON, Canada; 8US Outcomes Research, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USAAbstract: In this year-long, prospective observational study, sociodemographic, clinical, and functional characteristics were assessed in outpatients with schizophrenia from Australia, ­Mexico, Romania, and Taiwan who were switched from their primary oral antipsychotic to another oral or depot antipsychotic at study entry because of physician-perceived ­nonadherence risks. Patients (N = 406) rated their quality of life and functioning level as low. Few patients (10.6%, 43/406) were switched to depot antipsychotics, with country-specific differences (P < 0.001). Although illness severity was similar between subgroups, the depot switch ­subgroup had: a documented history of nonadherence (32.6% versus oral: 4.7%); recent alcohol (48.8% versus 23.2%; P < 0.001) or illicit drug use (16.3% versus 5.0%; P = 0.010); recent depot antipsychotic (20.7% versus 7.5%; P = 0.030) and mood stabilizer use (51.7% versus 26.3%; P = 0.008); poorer attitudes towards medication (P = 0.004); and poorer illness ­awareness (P = 0.041). Findings indicate that even when a risk of nonadherence has been identified, few patients with schizophrenia receive depot antipsychotics, despite being prime candidates for depot therapy. Findings suggest physicians may select depot therapy based on previous ­nonadherence, substance use, recent depot antipsychotic and mood stabilizer use, poor attitudes towards medications, and poor illness awareness.Keywords: antipsychotic drugs, schizophrenia, depot antipsychotic, nonadherence
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