European healthcare professionals’ use and experience with aripiprazole once-monthly 400mg two-injection start initiation regimen in adult patients with schizophrenia

Introduction Aripiprazole once monthly 400mg (AOM400) is a long-acting injectable (LAI) available with a two-injection start initiation regimen (AOM400-TIS) for the maintenance treatment of adult patients with schizophrenia stabilised with oral aripiprazole. Objectives This survey sought to explore the perspectives and experiences of HCPs using AOM400-TIS across Europe. Methods HCPs who had prescribed and/or administered the AOM400-TIS regimen to ≥3 patients with schizophrenia were invited to participate in an online survey. The survey was launched in two waves across the target countries (wave 1: Italy, Germany, United Kingdom (UK); wave 2: Denmark, Italy, Sweden). The survey aimed to understand HCPs’ perspectives and attitudes towards prescribing and/or administering AOM400-TIS according to the European label in clinical practice, including reasons for its use, potential benefits, and common barriers and/or concerns. Analysis was descriptive; data was collected between February 1–March 21, 2024 (wave 1) and September 16-October 28 (wave 2). Results 216 HCPs completed the survey (wave 1: 31 from Italy, 31 Germany, 32 UK; wave 2: 28 from Denmark, 64 Italy and 30 Sweden) including psychiatrists (67%) and psychiatric nurses (27%). HCPs estimated 30.0% (median; IQR: 20.0–50.0) of patients in their caseload were diagnosed with schizophrenia, and of these, 50.0% were treated with LAIs (median; IQR: 25.0–65.0). 46% of HCPs were primarily responsible for prescribing AOM400-TIS, 26% for administering it, and 28% were responsible for both. HCPs estimated that 42% of patients typically spent 14–28 days on oral aripiprazole prior to AOM400-TIS, with HCPs rating the severity of symptoms of patients initiated with AOM400-TIS as mild (18% of HCPs), moderate (65% of HCPs) and/or severe (53% of HCPs). The most common reasons for initiating AOM400-TIS after transitioning from oral aripiprazole were poor adherence (88%) and relapse(s) (52%), and the most reported goals for prescribing AOM400-TIS were to improve adherence (69%) and prevent relapses (64%). Common barriers to the use of AOM400-TIS were patient reluctance to receive two injections (55%), concerns about tolerability (34%) and safety of administering a high dose in a single day (35%). Prior treatment adherence (56%) and efficacy (46%) were the most cited factors influencing prescribing of AOM400-TIS. Overall, HCPs “agreed”, or “strongly agreed”, that AOM400-TIS was easy to administer (84%) and that it had a similar safety/tolerability profile to the single injection start regimen (60%), while the majority were satisfied with patient outcomes with AOM400-TIS (85%). Conclusions Overall, HCPs with experience of using AOM400-TIS reported that it is easy to administer, well tolerated, and improves treatment outcomes, while barriers to its use include patient reluctance and perceived safety concerns. Disclosure of Interest M. Yildirim Employee of: Murat Yildirim is a full time employee of H.Lundbeck A/S, Valby, Copenhagen., C. Beckham Employee of: Clodagh Beckham is a full-time employee of Otsuka Pharmaceutical Europe Ltd., Berkshire, UK., A. Fagiolini Grant / Research support from: Angelini, Boehringer Ingelheim, Lundbeck, Janssen, Otsuka, Pfizer, Recordati, Viatris, Consultant of: Angelini, Boehringer Ingelheim, Idorsia, Italfarmaco, Lundbeck, Janssen, Medicamenta, Mylan, Otsuka, Pfizer, Recordati, Rovi, Sunovion, Teva, Viatris, K. Leopold Grant / Research support from: Janssen, Otsuka, Consultant of: Boehringer Ingelheim, Lundbeck, Janssen, Otsuka Recordati, ROVI, Speakers bureau of: Boehringer Ingelheim, Lundbeck, Janssen, Otsuka Recordati, ROVI, W. Cottam Employee of: Will Cottam is a full-time employee of OPEN Health (London)., J. Hickey Employee of: Joe Hickey is a full-time employee of OPEN Health (London)., O. Rogerson Employee of: Olivia Rogerson is a full-time employee of OPEN Health (London)., S. Pappa Grant / Research support from: Recordati, Janssen, Consultant of: Lundbeck, Janssen, Otsuka, Recordati, Rovi, Gedeon Richter, Sunovion, Speakers bureau of: Lundbeck, Janssen, Otsuka, Recordati, Rovi, Gedeon Richter, Sunovion.