What is the Pharmacist’s Role In Long-Acting Injectables?
In recent years, pharmacies have started to expand their roles and responsibilities to better help serve their communities and help patient outcomes. There are a variety of initiatives and programs that community pharmacies can start to implement that could give their patients more access to the treatments they need for everyday life. One of these initiatives could lie in engaging pharmacists in the administration of long-acting injectables. Offering this service can help patients get better access to their medication and have better adherence with the medication.
What Are Long-Acting Injectables?
Long acting injectables are still the same medications that the patients were taking in oral form but are instead injected either under the skin or intramuscularly to allow for a slower release of medication into the bloodstream. Commonly, long acting injectables are used in patients that have mental health disorders such as schizophrenia (4). When first starting one of these injectables, a patient may also still need to take their oral medication for the first few weeks, so it allows time for the injectable to start working properly within their system. Some examples of these long acting injectables include aripiprazole, olanzapine, paliperidone, and risperidone (3).
Long-acting injectable antipsychotics (LAIA)
Long-acting injectable antipsychotics (LAIA) were specifically developed to help with the adherence issues that have been seen within the schizophrenia patients (2). There was a common occurrence seen where the oral antipsychotics were being discontinued by patients, so having an option where patients did not have to take a pill every day was ideal in this situation. Another benefit of LAIAs is that they have greater mortality benefit, hospitalization reduction, and quality of life compared to oral medication for patients with schizophrenia (2). For these reasons, more and more patients are getting switched to the injectable formulation to help optimize their outcomes.
The benefits of having this injection option for adherence purposes is optimal but has had its own problems due to accessibility issues of the medication. Traveling to receive these injectables, doctor’s office availability, and the stigma around getting treatment for mental health has created a significant barrier in accessibility of the long-acting injectables for these patients (2). Given that community pharmacies can be more accessible and flexible for patients, it presents an opportunity for pharmacists to help with this barrier of accessibility that is occurring for these patients (2).
pharmacists can help to bridge the gap for access to long-acting injectables
This unique position that pharmacists are in can help to bridge the gap for access to long-acting injectables. Pharmacists are also able to help with adherence and therefore overall outcomes in patients using these medications. If pharmacists were able to offer services to patients to receive their long-acting injectables by them instead of a doctor, this could help patients have better access to their medication and in turn maximize patient outcomes (2). Community pharmacist responsibilities have been growing throughout the years, so given their accessibility, it can be the perfect time to start to implement a new service, like administration of long-acting injectables.
How Accessibility Affects Adherence for LAIAs
Given that accessibility issues in turn can affect adherence, there was a study done to determine how adherence rates can be affected by having their LAIAs administered by a community pharmacist (1). The results of the study portrayed a 78% adherence rate to the LAIA’s when given by community pharmacists (1). The findings demonstrated that there could be value in implementing these programs in the community setting for patients to get better access to their medications. By helping patients overcome the barriers for accessibility, it benefits their adherence to the medications and improves their overall outcomes with these medications as well.
Net Benefit For Patients With Mental Illness Using LAIAs
Overall, considering the benefits that these long acting injectables show for patients struggling with mental illness it could be extremely beneficial for pharmacists to get the proper training for these medications. Bridging the accessibility gap could help more patients be able to use the long-acting injectables and be more adherent to them than they were with their past oral medications. If you are interested in participating in a specialty program for long acting injectables, we do offer one here on our website. Our program includes 5 continuing education modules that are self-paced that can aid pharmacists in certification or recertification. Within these modules everyone will learn how to properly administer long acting injectables and learn proper techniques. The program is linked below: Long- Acting Injectable Specialty Certification.
- Lin, C, Strauss, R, Hong, J, et al. Impact of a pharmacist-administered long-acting injectable antipsychotic service in a supermarket-based community pharmacy on medication adherence. J Am Coll Clin Pharm. 2019; 2: 343–348. https://doi.org/10.1002/jac5.1159
- Murphy AL, Suh S, Gillis L, Morrison J, Gardner DM. Pharmacist Administration of Long-Acting Injectable Antipsychotics to Community-Dwelling Patients: A Scoping Review. Pharmacy (Basel). 2023;11(2):45. Published 2023 Feb 27. doi:10.3390/pharmacy11020045
- VandenBerg AM. An update on recently approved long-acting injectable second-generation antipsychotics: Knowns and unknowns regarding their use. Ment Health Clin. 2022;12(5):270-281. Published 2022 Nov 3. doi:10.9740/mhc.2022.10.270
- Zolezzi M, Abouelhassan R, Eltorki Y, Haddad PM, Noorizadeh M. Long-Acting Injectable Antipsychotics: A Systematic Review of Their Non-Systemic Adverse Effect Profile. Neuropsychiatr Dis Treat. 2021;17:1917-1926. Published 2021 Jun 14. doi:10.2147/NDT.S309768