Finocchio Brittany, Hilliard Wanda
Karuna Therapeutics, Boston, Massachusetts, USA.
Texas Tech University Health Science Center, Lubbock, Texas, USA.
J Correct Health Care. 2024 Apr;30(2):71-81. doi: 10.1089/jchc.23.10.0089. Epub 2024 Mar 6.
The advantages of long-acting injectable antipsychotics (LAIs) in schizophrenia are well studied. However, forensic involvement is common in schizophrenia, and incarcerated individuals are often excluded from clinical trials. Nonadherence and oral medication diversion in forensic populations with schizophrenia, and the relationship between antipsychotic nonadherence and crime support LAI utilization in this subset of patients. Yet, federal regulations limit data generation in forensic populations. This review characterizes data on therapeutic outcomes of LAIs in correctional populations with schizophrenia-spectrum diagnoses. A search for primary literature was conducted in PubMed. Favorable effects of LAIs were observed on adherence, psychiatric symptomatology, patient satisfaction, health care costs, and frequency of criminal charges. Data were primarily retrospective and included small samples and individuals with historical versus current forensic involvement. Although limited, available literature and insights into the correctional system suggest advantages to LAI use in forensic populations. Barriers to conducting research in correctional settings must be addressed to facilitate further data generation.
长效注射用抗精神病药物(LAIs)治疗精神分裂症的优势已得到充分研究。然而,精神分裂症患者常涉及法律问题,被监禁者通常被排除在临床试验之外。患有精神分裂症的法律相关人群存在不依从和口服药物被挪用的情况,而且抗精神病药物不依从与犯罪之间的关系支持在这部分患者中使用LAIs。然而,联邦法规限制了针对法律相关人群的数据生成。本综述描述了患有精神分裂症谱系诊断的惩教人群中LAIs治疗效果的数据。在PubMed上检索了相关的原始文献。观察到LAIs在依从性、精神症状、患者满意度、医疗保健成本和刑事指控频率方面有积极作用。数据主要是回顾性的,样本量较小,且包括有既往或当前法律相关问题的个体。尽管数据有限,但现有文献以及对惩教系统的见解表明,在法律相关人群中使用LAIs有优势。必须解决在惩教环境中开展研究的障碍,以促进进一步的数据生成。