Attitudes DriVing Regional Differences in LAI ANtipsychotic Utilization for Schizophrenia Among HCPs, Patients, and CaregivErs (ADVANCE): Social Listening Assessment
Authors: Franzenburg Kelli R. , Merlin Matthew , Peng Sisi , Kurylo Chad , Sedigh Kameron , Gonzalez Alma , Suett Mark , Hansen Rolf T. 
Published: January 2025

Introduction

The prevalence of schizophrenia is relatively low, yet increasing globally, and the disorder imparts a substantial burden of disease on both individuals and health systems. With regard to schizophrenia treatments, including long-acting injectable antipsychotics (LAIs), social media listening provides a unique source of insight into the experiences and perceptions of healthcare professionals (HCPs), patients, and caregivers who live with and manage this disorder daily.

Objective

To gain insight into HCP and patient/caregiver perceptions of LAIs for the treatment of schizophrenia.

Methods

Publicly available online conversations in global English about LAIs for schizophrenia from May 2, 2022, to May 2, 2023, were analyzed. Posts were collected using customized search strings from social media analysis tools, including Talkwalker and Meltwater. Online forums, such as Reddit, were the main source for patient/caregiver conversations. Conversations among HCPs were examined using publicly available posts from Twitter about schizophrenia/LAIs. Random samples of posts on forums (100) and Twitter (100) were coded for primary topic, author type (patient, caregiver, or HCP), sentiment toward LAIs, and signs of LAI hesitancy. Additional topics in posts, such as barriers and benefits to LAI use, were also examined.

Results

In the analyzed samples, some differences were observed between patients/caregivers (mostly patients) and HCPs (mostly psychiatrists) in lexicon, focus, and perspective. The most common terms for LAIs among patients/caregivers were “injection” or “shot,” while HCPs used the terms “LAIs” or “injectables.” The most frequent primary topic among patients/caregivers was treatment regimen, including impact of symptoms and side effects on quality of life. HCPs focused on drug efficacy, including broader health outcomes such as relapse, hospitalization, adherence, and mortality. Patients/caregivers expressed fewer positive sentiments (11% of posts) and more negative sentiments (35%) than HCPs (34% positive, 14% negative). Both groups noted reduced relapse and improved adherence among the top treatment benefits. Barriers to LAI use commonly cited by patients/caregivers included side effects and lack of effect on negative symptoms, while common barriers cited by HCPs included patient access/cost and limited knowledge around best prescribing practices. Treatment comparisons and/or switching were more commonly mentioned among patients/caregivers (51%) than HCPs (30%), suggesting a greater interest in optimizing treatment among patients. Patients/caregivers often compared individual LAIs with oral antipsychotics (OAs) or different LAIs, whereas it was more typical for HCPs to compare LAIs with OAs than to distinguish between different LAIs.

Conclusions

Based on social media posts, patients/caregivers and HCPs had different primary treatment goals/concerns and generally used different lexicons, which may affect communication. Overall, HCPs were more positive and less negative toward LAIs than patients/caregivers. Top benefits noted (relapse and adherence) were similar between groups, while top treatment barriers differed. These differences highlight the need to improve communication between patients/caregivers and HCPs in order to increase treatment satisfaction and potentially improve treatment outcomes.

Funding

Teva Branded Pharmaceutical Products R&D, Inc.