Survey: Providers Prioritize QoL, Long-Term Care in BPD, Schizophrenia

A new national survey reported that healthcare providers prioritize quality of life, long-term symptom management, and treatment consistency for patients with bipolar I disorder and schizophrenia.1

Conducted online by The Harris Poll on behalf of Alkermes in September 2024, the survey included 127 psychiatrists and 126 nurse practitioners/physician assistants who see ≥ 10 patients with bipolar I disorder and ≥ 2 patients with schizophrenia per month. Most (75%) practiced in an in-office or clinic-based setting, such as a private office (49%), community mental health clinic (17%), and a general health clinic/federally qualified health center (5%).

The survey reported that medication adherence was a top concern for healthcare providers when selecting treatments for bipolar I disorder (36%) and schizophrenia (41%). Other concerns included manic (32%) and depressive (31%) episodes for bipolar I disorder, and patients’ ability to take medication as prescribed (41%) and maintain independence and complete daily living activities (38%).

Common treatments for patients with bipolar I disorder included mood stabilizers (58%), oral antipsychotics (53%), antidepressants (24%), medication for adverse events of antipsychotics (12%), and long-acting injectable antipsychotics (12%). Common treatments for patients with schizophrenia included oral antipsychotics (69%), long-acting injectable antipsychotics (27%), mood stabilizers (25%), antidepressants (23%), and medication for adverse events of antipsychotics (23%).

Providers reported that patients with bipolar I disorder and schizophrenia switch medications an average of 7 and 8 times in their lifetime, respectively. The most common reasons for switching medications were perceived ineffectiveness (83%) and adverse events (81%).

Frequently changing medications can have a significant impact on a patients’ quality of life, as reported by 77% of providers, and make symptom control difficult (76%). Nearly all providers (98%) agreed that quality of life considerations is as important as symptom management.

As Christoph Correll, MD, from Feinstein Institutes for Medical Research, told HCPLive in July, some patients may think that if they miss a dose and see a short-term improvement, they no longer need the medication.2 However, this is not true. Symptoms can return, and so can associated risks of schizophrenia, such as hospitalizations, relapses, mortality, and poor functioning.

Regarding new treatments, providers reported in the survey often taking a measured approach to consider clinical guidelines, accessibility, and individual patient circumstances.1 31% of providers reported incorporating advancement quickly, whereas 59% wait for more data. 10% are unlikely to use or try new treatments until they have been included in standards of care.

Providers said they would be more likely to incorporate new treatments for their patients if it was added to clinical guidelines (68%) or were generally accessible through public or private insurance (65%).

When selecting a treatment option for patients, providers prioritize medication adherence (15%), strong clinical research (15%), and prior patient experiences (13%). The most valued medication outcomes included fewer symptoms (44%), independence (38%), and long-term adherence (30%). They also believed it was important for patients to be able to take their medication as prescribed (28%), develop and achieve life goals (27%), and have less frequent and more tolerable adverse events (25%).

Providers believe important measures of treatment efficacy include symptom management (bipolar: 98; schizophrenia: 97%), quality of life improvement (bipolar: 96%; schizophrenia: 94%), manageable adverse events (bipolar: 92%; schizophrenia: 92%), long-term maintenance (bipolar: 91%; schizophrenia: 91%), long-term treatment without switching medication (bipolar: 86%; schizophrenia: 88%), and stabilized symptoms (bipolar: 83%; schizophrenia: 81%).

The survey also found that most providers (97%) often look for treatment options that minimize the number of different treatments their patient needs at once.

“The perspectives of healthcare providers captured in this survey are valuable in helping to understand the path that patients may navigate following a schizophrenia or bipolar I disorder diagnosis,” said Kanchan Relwani, MD, senior vice president of medical affairs at Alkermes, in a statement. “These insights help inform and characterize the barriers and opportunities that exist to advance care."

References

1. New National Survey of Healthcare Providers Offers Insights into the Dynamic and Challenging Treatment Journey for People Living with Schizophrenia or Bipolar I Disorder. PR Newswire. March 27, 2025. https://www.prnewswire.com/news-releases/new-national-survey-of-healthcare-providers-offers-insights-into-the-dynamic-and-challenging-treatment-journey-for-people-living-with-schizophrenia-or-bipolar-i-disorder-302412777.html. Accessed March 28, 2025.

2. Derman, C. Improving Schizophrenia Management: A Patient's Call to Care Providers. HCPLive. July 24, 2024. https://www.hcplive.com/view/improving-schizophrenia-management-a-patient-s-call-to-care-providers. Accessed March 28, 2025.