In this video interview, Melissa Malinoski, PA-C, shares her perspective on the benefits and challenges of long-acting injectables (LAIs) in patient care. She discusses how LAIs can improve treatment adherence, particularly for patients who struggle with remembering daily medications, and highlights the added convenience they bring to patients’ lives. By reducing the need for daily dosing, LAIs not only simplify treatment routines but also empower patients to focus more on living their lives rather than managing medications.
Malinoski also emphasizes the importance of early conversations between clinicians and patients about LAI options, noting that many patients may not even be aware these treatments exist. She addresses common concerns such as injection discomfort and cost while underscoring the role of clinicians in supporting patients through education, validation, and access to copay assistance programs.
Pharmacy Times: From your clinical experience, what are the main advantages of long-acting injectables compared to daily oral antipsychotics for patients with schizophrenia?
Melissa Malinoski, PA-C: In my experience, the main advantage is convenience. They’re much more convenient than having to take a pill every day or trying to remember whether you’ve already taken one, which could result in an extra dose. They also allow people to simply live their lives—for example, if they’re outside or away from home when it’s time to take a pill, it no longer matters.
Pharmacy Times: What factors do you consider when determining whether a patient is a good candidate for a long-acting injectable, and how do you approach that discussion with them?
Malinoski: Patients can be good candidates for a lot of reasons. If they have trouble remembering to take a pill daily, that is a great opportunity. Sometimes they’ll even say, “I’m really bad about taking pills every day.” They often prefer this option. In some cases, it can be part of the disease process—for example, thinking they don’t need medication. Or maybe they’re just really busy, traveling, or not home much of the time, and they prefer to get an injection once a month at the clinic.
Pharmacy Times: Adherence is often a challenge in schizophrenia treatment—how have you seen LAIs impact adherence and overall patient outcomes in your practice?
Malinoski: I think LAIs are a wonderful tool because they can be almost self-reinforcing. When a patient receives the medication, they may gain insight into their condition—or they may not—but it can still help. For example, if they feel better, are thinking more clearly, or their voices have decreased, that improvement can reinforce the importance of staying on their medication.
Pharmacy Times: What are some of the common concerns patients or their families raise about LAIs, and how do you address those concerns?
Malinsoki: The main concern patients raise is whether the shot will hurt. They don’t want an injection, but I try to validate their concerns and remind them that it’s just one quick poke, and then it’s done for the whole month. They can also use ice or heat on the area afterward if necessary. Sometimes caregivers are more concerned about the cost of the medication, so I work with them or with specialty pharmacies to acquire it. Many companies offer copay assistance programs, whether through vouchers, savings cards, foundation support, or free samples.
Pharmacy Times: Looking ahead, how do you see the role of LAIs evolving in mental health care, and what innovations are you most excited about?
Malinoski: I would love to see more options for LAIs of medications that are currently only available in oral form, because one medication doesn’t work for everyone. If a patient is doing really well in terms of symptom control and disease management on an oral medication but struggles to remember to take it regularly, I would love to see that medication offered as an LAI option for them.
Pharmacy Times: Is there anything else you would like to add?
Malinoski: I think LAIs are a wonderful tool, and I would encourage clinicians to have a conversation with their patients sooner rather than later—just letting them know it’s an option. In my experience, some patients do prefer the convenience, and they may not even realize it’s available to them.