The British Journal of Psychiatry (2009) 195: S57-S62. doi: 10.1192/bjp.195.52.s57
© 2009 The Royal College of Psychiatrists
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit an eLetter
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Lambert, T. J.
Right arrow Articles by Patel, M. X.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lambert, T. J.
Right arrow Articles by Patel, M. X.

Community treatment orders and antipsychotic long-acting injections

Tim J. Lambert, BSc, MBBS, PhD, FRANZCP

Discipline of Psychological Medicine, Brain and Mind Research Institute, University of Sydney, Camperdown, New South Wales

Bruce S. Singh, MBBS, PhD, FRACP, FRANZCP

Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia

Maxine X. Patel, BSc, MSc, MBBS, MRCPsych

Division of Psychological Medicine, Institute of Psychiatry, King's College London, UK

Correspondence: Dr Maxine Patel, Division of Psychological Medicine, Box 68, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. Email: m.patel{at}iop.kcl.ac.uk

Declaration of interest

M.P. has been reimbursed for attendance at scientific conferences and has received consultation fees from Janssen-Cilag and Eli Lilly; she has received investigator-initiated grants from Janssen-Cilag and Eli Lilly and has previously worked on two clinical drug trials for Janssen-Cilag. T.L. has consulted to and received educational and research grants from Eli Lilly and Janssen-Cilag. B.S. has consulted to and received speaker's fees from Eli Lilly and Janssen-Cilag.

Background

The community treatment order (CTO) is the legal framework by which people in the community are compelled to accept treatment. Both antipsychotic long-acting injections (LAIs) and CTOs are used to address treatment non-adherence.

Aims

To investigate the relationship between CTOs and LAI use in patients with schizophrenia.

Method

Prescribing, demographic and CTO data were collected for patients from four community mental health clinics in Melbourne, Australia, in 1998 and 2002.

Results

Against a background of increasing use of oral second-generation antipsychotic (SGA) medication and decreasing use of LAIs, the rates of CTO implementation doubled from 13% to 26% of patients with schizophrenia between 1998 and 2002. Proportionally more patients with a CTO are prescribed LAIs rather than oral SGAs.

Conclusions

The relationship between receiving an LAI and being subject to a CTO is significant, and reflects the consideration given to enhancing adherence in a community mental health setting.