2026 ECNP Congress

PS02-2245

Patient and caregiver preferences for long-acting injectable treatments in schizophrenia: a discrete choice experiment

Alejandra Guevara Morel — A.J. Cutler, E. Parellada, S. Lim, K.R. Franzenburg, Y. Zhang, H. Mechiche, T. Tervonen, A. Jager, C. Jimenez Moreno, S. Leucht · Teva Pharmaceuticals Europe B.V., Global Health Economics- Value- and Outcomes, Haarlem, Netherlands

2026 ECNP Congress

Background

Long-acting injectable (LAIs) antipsychotics have demonstrated benefits over oral antipsychotics in improving adherence and reducing hospitalisation and relapse rates in patients with schizophrenia, yet are underutilised in clinical practice. The aims of this study were to assess patient and caregiver preferences for key treatment attributes in schizophrenia and examine how participant characteristics influence these preferences. These objectives were part of a larger study that also included healthcare professionals.

Methods

This cross-sectional preference study used discrete choice experiment (DCE) methodology and included patients and caregivers from Canada, Germany, Spain, the United Kingdom, and the United States. The DCE was developed via targeted literature review, a study design workshop, and input from clinical experts, and was tested via cognitive pilot interviews and a quantitative pilot. Primary treatment-related attributes examined included: (1) frequency and mode of administration (daily oral pills, monthly subcutaneous injection without loading dose, monthly intramuscular injection without loading dose, monthly intramuscular injection with loading dose); (2) post-injection monitoring (none, 3 hours in clinic); (3) weight gain (0 kg, 5 kg, 10 kg); (4) risk of post-injection delirium/sedation syndrome (PDSS) (none, 2%); (5) severity of hallucinations and delusions (minimal, moderate, severe); (6) severity of hostility and aggression (minimal, moderate, severe); and (7) risk of hospitalisation due to relapse (5%, 10%, 15%).

Results

This study included 436 adult patients with schizophrenia (median age 35 years; 60% male; 76% diagnosed with schizophrenia ≤10 years previously) and 162 caregivers of adults with schizophrenia (median age 36 years; 59% male). Most patients reported experience with oral antipsychotics (86%); fewer reported experience with LAIs (42%). The majority (52%) had tried 1–3 schizophrenia medications.

Among caregivers, most (67%) had provided 2–5 years of care to patients (median age, 49 years); 78% of their care recipients had taken oral antipsychotics and 61% had taken LAIs. In the DCE, all 7 attributes significantly impacted patients’ treatment choices; 4 of 7 significantly impacted caregivers’ choices (severity of hallucinations and delusions, severity of hostility and aggression, risk of hospitalisation due to relapse, and weight gain). Impact on hallucinations and delusions was the highest ranked attribute (relative attribute importance [RAI]: patients 28.4%, caregivers 29.3%), followed by hostility and aggression (RAI: patients 20.7%, caregivers 28.5%), and reduced hospitalisation risk (RAI: patients 18.0%, caregivers 18.0%). Overall, patients were willing to accept up to a 15.8% increase in hospitalisation risk for hallucinations and delusions to be minimal instead of severe, and up to an 11.5% increased hospitalisation risk for hostility and aggression to be minimal instead of severe. Patients with no LAI experience valued oral pills daily over monthly subcutaneous injection more than patients with LAI experience, who expressed no preference among different modes of administration.

Conclusions

Patient and caregiver preferences were primarily influenced by clinical stability measures, with patients also valuing practical dosing considerations. To improve appropriate LAI use in clinical practice, educational efforts for patients and caregivers should focus on LAI efficacy and potential for simplified treatment logistics, particularly for LAI-naive patients.

References

No references