Impact of Healthcare Professional Role and Care Setting on Attitudes Toward Long-Acting Injectable Antipsychotics for Schizophrenia: A Subgroup Analysis of the Multinational ADVANCE Study

Abstract Background This analysis of the multinational ADVANCE study evaluated how the healthcare professional’s (HCP’s) role and setting of care influence attitudes, perceptions, and utilization of long-acting injectable antipsychotics (LAIs) for schizophrenia treatment. Design A cross-sectional survey was conducted among HCPs from eight countries, capturing data on practice characteristics, LAI prescribing behaviors, confidence, and challenges related to LAIs, and treatment objectives. Results A total of 791 HCPs were categorized by role (psychiatrist [n = 490] or psychiatric nonphysician [n = 301]) and by setting of care (inpatient psychiatric ward [n = 260], hospital-based outpatient clinic [n = 174], community/psychiatric outpatient clinic [n = 227], and independent practice [n = 107]). Psychiatrists were more likely to identify as early users of LAIs and demonstrated higher confidence with LAI use than psychiatric nonphysicians, who, despite lower confidence and lower likelihood of prescribing LAIs, reported higher patient acceptance rates at first recommendation. Among care settings, inpatient psychiatric ward HCPs had the highest likelihood of prescribing LAIs but the lowest confidence levels, whereas independent practice HCPs exhibited high confidence yet the lowest likelihood of prescribing LAIs. Independent practice HCPs reported having the least support staff and cited lack of time as a challenge to LAI use, suggesting systemic barriers and HCP burden may influence LAI utilization. Conclusions Together, these findings underscore the importance of tailored educational resources addressing both the HCP’s role and practice environment to enhance confidence, facilitate effective patient discussions, and ultimately improve LAI utilization.