Community treatment orders and antipsychotic long-acting injections

Br J Psychiatry Suppl. 2009 Nov:52:S57-62. doi: 10.1192/bjp.195.52.s57.

Abstract

Background: The community treatment order (CTO) is the legal framework by which people in the community are compelled to accept treatment. Both antipsychotic long-acting injections (LAIs) and CTOs are used to address treatment non-adherence.

Aims: To investigate the relationship between CTOs and LAI use in patients with schizophrenia.

Method: Prescribing, demographic and CTO data were collected for patients from four community mental health clinics in Melbourne, Australia, in 1998 and 2002.

Results: Against a background of increasing use of oral second-generation antipsychotic (SGA) medication and decreasing use of LAIs, the rates of CTO implementation doubled from 13% to 26% of patients with schizophrenia between 1998 and 2002. Proportionally more patients with a CTO are prescribed LAIs rather than oral SGAs.

Conclusions: The relationship between receiving an LAI and being subject to a CTO is significant, and reflects the consideration given to enhancing adherence in a community mental health setting.

MeSH terms

  • Adult
  • Antipsychotic Agents / administration & dosage*
  • Antipsychotic Agents / therapeutic use
  • Australia
  • Chi-Square Distribution
  • Commitment of Mentally Ill / legislation & jurisprudence
  • Community Mental Health Services / legislation & jurisprudence*
  • Delayed-Action Preparations / administration & dosage*
  • Delayed-Action Preparations / therapeutic use
  • Female
  • Humans
  • Injections
  • Male
  • Mandatory Programs / legislation & jurisprudence*
  • Patient Compliance
  • Schizophrenia / drug therapy*
  • Treatment Outcome

Substances

  • Antipsychotic Agents
  • Delayed-Action Preparations