Pharmacists Bridging the Gap: Enhancing LAI Management Through Collaborative Care Teams

Long-acting injectables (LAIs) offer a promising approach to schizophrenia treatment, but their effective use requires careful management and patient education. In this interview, Michael McGuire, PharmD, discusses the critical role of pharmacists in optimizing LAI therapy. He highlights the importance of open communication between health care providers, patient education initiatives, and standardized tracking tools to ensure successful LAI implementation and improved outcomes for individuals with schizophrenia. The discussion also explores the challenges and opportunities associated with LAI use, emphasizing the need for collaborative care models and enhanced patient support systems.

Pharmacy Times: What strategies can be implemented to improve communication and collaboration between pharmacists, prescribers, and other members of the health care team to facilitate the appropriate and timely use of LAIs for patients with schizophrenia?

Michael McGuire: Yeah, I think there just has to be open communication between all of the providers. Not just the prescriber, but everybody involved in the patient's care, establishing rapport and trying to build that trust. If pharmacists are administering in the community, then they could be a great source of information for a mental health provider. They could be another point of contact and providing information back to the mental health center or the mental health prescriber of a patient coming in for their injection. And, you know, maybe there were signs and symptoms of an impending decompensation. Maybe the patient was doing well. So, that open communication back and forth could be really beneficial if pharmacists are administering in the community and in the hospital. Again, we're a good source to provide information on these products and ensure appropriate utilization and appropriate selection of the products.

Pharmacy Times: What resources or tools do you find most helpful to effectively counsel patients about LAIs?

McGuire: So, my go-to [resource] is always the product websites and package insert. I tend to rely on package inserts myself, because especially with the newer LAIs, they tend to be very specific for late dosing, missed doses, dose conversions, and those kinds of things. For patients, I really like giving product-specific education. I think it would be nice if there was unbranded information that we could give patients that talked about LAIs broadly and the benefits of LAIs, particularly with LAIs versus oral medications and using LAIs, resulting in decreased hospitalizations and improved functioning overall. I would really like to see almost like when everybody was getting their COVID-19 vaccines and everybody carried around their COVID vaccine card, right? And here's the date of your first injection; here's the date of your second injection. It would be great if there were LAI wallet cards that patients kept with them that said, ‘I'm on this product. This is the last time I had it, and this is where I got it.’ Every state has a controlled substance database that I can go into and look at and see the last time they had some alprazolam filled. But I can't do that for long-acting injectables. And again, this is an opportunity for medication errors to occur really easily.

Pharmacy Times: In your experience, what is the value of the pharmacist in managing LAIs and schizophrenia treatment in general?

McGuire: What I have seen is that there is a tremendous opportunity for us, and I think it's been one of the ways that I've been able to continue to establish and continue to show my value. As a professor, I talk about these products in class, and then my students come out and they see us trying to figure out when did the patient last get their injection? And they see that we really are struggling with this fragmented health system that we work in, and unfortunately, our patients with chronic, persistent mental illness don't navigate this system well. And it's hard enough for me to navigate the system for myself, much less for somebody with a chronic mental illness. And if we can help them, we can improve their overall care and the overall outcomes for their illness.