Video transcript
Terence:
So, if we’re going to teach somebody new who wants to start recommending long-acting injectables, the first thing I would let them know is take off your hat or your suit as a clinician and come down to the patient's level. That's the first thing. When you come down to the patient level, it makes it easier for you to talk to the patient. Second thing would be think about the patient's goals. Put that together with introducing long-acting injectables with the goal of the patient. And we don't want big goals. Easy goals. Right? If your goal is to be able to get up in the morning and go to the grocery store and come back, that maybe the long-acting injectable may be your way towards that goal. And then, last, but not the least is do it early. Don't wait. The first time you meet a patient, let them know there's that option, and then let the patient…and don't give up if the patient doesn't take to that option the first time just keep bringing it back. And then maybe one day they may choose to take it. And you would have succeeded.
Mia:
What I would say to a peer, either psychiatrist or nurse practitioner that they have thought about and know about long-acting injectable, but they are reluctant to take that first step and put a patient in a long-acting injectable. I would tell them, first of all, that we know that there are patients unfortunately, they don't take the medication as prescribed. It’s as simple as, go and look at the prescription lists of your patients and how often they pick up the medication. See also how often they relapse. And give them a chance that you're going to be a little bit more involved in the treatment by you being the one that you are sure that the patient has the medication in their system, and how will it be? By giving a long-acting injectable. You know what day the patient had the medication, you know the medication in their system, and you're able to look how the symptoms are doing with that patient. At the same time, when I bring it up to them about long-acting injectables, I'm not saying I'm going to put you in a long-acting injectable (LAI). I say, we are going to do this for the treatment of your illness. So, we're going to work as a treatment team. I'm the one prescribing it, I'm the one that has the responsibility of being sure that you get the injection and you're the one to tell me how you're doing with it. So, when I explain, when I'm explaining to my patients, I'll let them know that it's paliperidone palmitate. Once a month, once every three months, every six months, it’s the same molecule. The difference is how long it's going to be in their system.
Linda:
So, for peers or colleagues that have never used or prescribed an LAI, I would say, once you start using LAIs and you educate yourself about it and you get familiar with them, it's no longer intimidating. And once it's no longer intimidating, it becomes second nature. You are able to offer it, and you're able to be confident in prescribing it and providing the injection. Yeah. So, first of all, the biggest point is that I need to make sure they're in acceptance of their diagnosis. And once they are, we talk about treating them. And I tell them, hey you know what we're going to start you on an oral antipsychotic medication first to make sure that you're tolerating it. Once we know that you're tolerating it, we'll move on to one-month injection. And potentially, if you do well in that one-month injection for a few months, we can potentially move you over to a six-month injection and at that point we're at a point where you're only seeing me in person potentially twice a year, and we can manage this condition and manage it well. Outside of that, I would encourage my peers who work in psychiatry to learn about LAIs because we're supposed to be the ones with the most up-to-date knowledge in our field. We're supposed to be the specialists in our field. So, if you're not using an LAI, then you're not really up to date with managing schizophrenia.
LAI=long-acting injectable.