The British Journal of Psychiatry (2009) 195: S51-S56. doi: 10.1192/bjp.195.52.s51
© 2009 The Royal College of Psychiatrists
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REVIEW ARTICLES

Antipsychotic long-acting injections in clinical practice: medication management and patient choice

Richard Gray, RN, PhD, Faculty of Health

University of East Anglia, Norwich

Rosalyn Spilling, RN, BSc and David Burgess, RN, MSc

Mental Health Nursing, University of East Anglia, Norwich

Tim Newey, mental health service user

Bromley, Kent, UK

Correspondence: Professor Richard Gray, Faculty of Health, University of East Anglia, Norwich NR4 7TJ, UK. Email: richard.gray{at}uea.ac.uk

Declaration of interest

R.G. has received funding and/or fees from AstraZeneca Pharmaceuticals, Bristol-Myers Squibb, Janssen Pharmaceuticals, Eli Lilly, Otsuka Pharmaceuticals and Pfizer.

Background

A patient-centred approach to care, focusing on recovery, demands a reconsideration of how choices are made about treatment, how this affects medication adherence, and the role of long-acting antipsychotics (LAIs) in this process.

Aims

To explore the role of the mental health professional (particularly nurses) in helping patients manage their medication, with a specific focus of the use and administration of LAIs.

Method

A pragmatic review of the literature.

Results

Patients (by experience) and mental health professionals (by training and clinical practice) are experts in the care and treatment of psychosis. When patients and clinicians make a joint decision both are more likely to adhere to the treatment plan. In this paper we consider good practice in the administration of LAIs that focuses on where and when they should be given and administration techniques. Skills for talking with patients about their medication that include exchanging information, monitoring the effects of medication and making advance choices about treatment in the event of a crisis are also discussed.

Conclusions

Mental health professionals require a range of competences to help patients manage their medication effectively.