Problems with the Administration of Antipsychotic Drugs in Depot Formulations in the Treatment of Schizophrenia - - - Problemi u primeni antipsihotika u obliku depo preparata u lečenju shizofrenije
Journal Title: Acta Facultatis Medicae Naissensis - Year 2018, Vol 35, Issue 1
Abstract
The aim of this study was to investigate problems with the administration of antipsychotic long-acting injections (LAIs) in patients with schizophrenia. Besides many benefits, long-acting injections have been asso-ciated with a number of complications at the site of the injection. The qualitative study included four medical workers and five patients who had been treated with fluphenazine, haloperidol, risperidone given in the form of a long-acting depot injection. The data were collected by direct observation, analysis of the history of the disease and used semi-structured interview. Interviews completed by patients, psychiatrists and nurses were analyzed and condensed into nine key categories: Competence and training of the medical workers, Sites and technique, Registration of complications, Care of patients and privacy, Availability and evidence, Duration and frequency of treatment, Burden for the patients, The choice of formulation therapy, and Sense of stigma. Monitoring of side-effects of LAIs was not extensive and doctors did not write adverse effects. The nurses who administered the injections were competent. Not enough attention is paid to the choice of the needle diameter and the patient was not given a choice to decide on the sites of the administraton of injection. Three out of five patients did not feel any changes at the injection site, but another patient had severe pain, redness, and induration. The exchange of information, a possibility of choosing the site of administration, and monitoring of the effects of treatment are all positive strategies that doctors and nurses can use to help patients in the compliance to the treatment with antipsychotic long-acting injections. - - - Cilj ovog istraživanja bio je ispitivanje problema kod primene antipsihotika u obliku depo preparata u lečenju shizofrenije. Pored mnogih prednosti, dugodelujuće injekcije antipsihotika su povezane sa brojnim komplikacijama na mestu primene. U kvalitativnoj studiji učestvovala su četiri medicinska radnika i pet bolesnika na terapiji lekovima: flufenazin, haloperidol i risperidon dati u obliku depo injekcija. Podaci su prikupljani direktnim posmatranjem, analizom istorija bolesti i semistruktuiranim intervjuom. Analizirajući intervjue bolesnika, psihijatara i medicinskih sestara dobijeni rezulati su podeljeni u devet ključnih kategorija: kompetencija i obučenost medicinskih radnika, mesto i tehnika primene injekcija, praćenje komplikacija i neželjenih dejstava, briga o bolesniku i njegovoj privatnosti, dostupnost i evidentiranje terapije, trajanje i učestalost tretmana, opterećenje bolesnika, izbor formulacije terapije i prisustvo osećaja stigme. Praćenje neželjenih efekata antipsihotika u obliku depo preparata se ne vrši u dovoljnom obimu, kao ni evidencija od strane lekara. Medicinske sestre su obučene za davanje dugodelujućih injekcija. Nedovoljno pažnje se posvećuje izboru prečnika igle, a pacijentu nije data mogućnost da izabere mesto ubrizgavanja leka. Promene na mestu primene leka nisu imala tri od pet pacijenata, dok su kod preostalih bili prisutni jaki bolovi, crvenilo i induracija. Razmena informacija, mogućnost izbora mesta primene leka i praćenje neželjenih dejstava predstavljaju pozitivne strategije koje lekari i medicinske sestre treba da koriste da bi komplijantnost bolesnika bila bolja tokom primene dugodelujućih injekcija antipsihotika.
Authors and Affiliations
Anica Ranković, Slobodan Janković
Keywords
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- DOI 10.2478/afmnai-2018-0007
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Problems with the Administration of Antipsychotic Drugs in Depot Formulations in the Treatment of Schizophrenia - - - Problemi u primeni antipsihotika u obliku depo preparata u lečenju shizofrenije
The aim of this study was to investigate problems with the administration of antipsychotic long-acting injections (LAIs) in patients with schizophrenia. Besides many benefits, long-acting injections have been asso-ciated...