ABSTRACT
BACKGROUND: The COVID-19 pandemic substantially impacted care of patients with schizophrenia treated with long-acting injectable antipsychotics (LAIs). This study examined how clinics adapted operations to maintain a standard of care for these patients after pandemic onset. METHODS: Online surveys were completed in October-November 2020 by one principal investigator (PI) or PI-appointed designee at 35 clinics participating in OASIS (NCT03919994). Items concerned pandemic impacts on clinic operations, particularly telepsychiatry, and on the care of patients with schizophrenia treated with LAIs. RESULTS: All 35 clinics reported using telepsychiatry;20 (57%) implemented telepsychiatry after pandemic onset. Telepsychiatry visits increased from 12%-15% to 45%-69% across outpatient visit types after pandemic onset;frequency of no-show and/or canceled telepsychiatry visits decreased by approximately one-third. Nearly half of clinics increased the frequency of telepsychiatry visits for patients with schizophrenia treated with LAIs. Approximately one-third of participants each reported switching patients treated with LAIs to longer injection interval LAIs or to oral antipsychotics. The most common system/clinic- and patient-related barrier for telepsychiatry visits was lower reimbursement rate and access to technology/reliable internet, respectively. Almost all participants (94%) were satisfied with telepsychiatry for maintaining care of patients with schizophrenia treated with LAIs;most predicted a hybrid of telepsychiatry and office visits post-pandemic. CONCLUSIONS: Changes made by clinics after pandemic onset were viewed by almost all participants as satisfactory for maintaining a standard of care for patients with schizophrenia treated with LAIs. Most participants predicted continuing telepsychiatry to support patient care post-pandemic;equitable access to telepsychiatry will be important in this regard. FUNDING: Alkermes, Inc.
ABSTRACT
Background and aims: Hereditary transthyretin amyloidosis (hATTR) is a rare, progressive, systemic, fatal condition in which misfolded transthyretin proteins form amyloid in tissues and organs, often manifesting in polyneuropathy (hATTR-PN). The FDA has approved 2 gene-silencing pharmacotherapies for hATTR-PN: inotersen, administered subcutaneously;and patisiran, administered intravenously. Patient satisfaction for each treatment was examined during a period overlapping with the COVID-19 pandemic. Methods: Patients with hATTR-PN (with and without accompanying cardiomyopathy) in the United States participated in an observational, online survey between January 1 and October 25, 2020. The Treatment Satisfaction Questionnaire for Medication, version II (TSQMvII), was administered to 29 patients currently being treated with inotersen (n = 11) or patisiran (n = 18). TSQMvII produces 4 scale scores—Effectiveness, Side Effects, Convenience, and Global Satisfaction—ranging from 0 to 100. Higher scores indicate greater satisfaction. TSQMvII scores were descriptively compared between treatment groups. Results: Patients receiving inotersen indicated greater satisfaction with convenience than patients receiving patisiran (mean, 76.3 [SD = 19.4] vs 58.6 [15.3], respectively), and less dissatisfaction with treatment side effects (86.1 [16.4] vs 68.3 [19.0]). Ratings were comparable between treatments with respect to effectiveness (72.0 [21.5] vs 67.1 [19.7]) and global satisfaction (78.0 [20.0] vs 74.5 [21.7]). Conclusions: While inotersen and patisiran were rated similarly in effectiveness and overall treatment satisfaction, inotersen was associated with less dissatisfaction with side effects and greater convenience, with the latter possibly reflecting differences in mode of administration (ie, at home vs visit to a clinical site), which may be particularly important during a pandemic.