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Batool Haider,1 Amy K O’Sullivan,1 Leona Bessonova,1 Elizabeth Keane,1 Eric Achtyes,2 Philip D Harvey,3 John M Kane,4 Stephen R Saklad,5 Jeffrey P Trotter,6 Amy Claxton,1 Tiffany Polak,1 James McGrory,1 Wahidullah Noori,1 Asia Sikora Kessler,7 Aaron Yarlas,7 Dawn Velligan8 1Alkermes, Inc, Waltham, MA, USA; 2Cherry Health and the Michigan State University College of Human Medicine, Grand Rapids, MI, USA; 3University of Miami Miller School of Medicine, Miami, FL, USA; 4The Zucker Hillside Hospital, Glen Oaks, NY, USA; 5College of Pharmacy, University of Texas at Austin, Pharmacotherapy Division, San Antonio, TX, USA; 6Worldwide Clinical Trials, Research Triangle, NC, USA; 7QualityMetric Incorporated, LLC, Johnston, RI, USA; 8University of Texas Health Science Center at San Antonio, San Antonio, TX, USACorrespondence: Batool Haider, Alkermes, Inc, 852 Winter Street, Waltham, MA, 02451-1420, USA, Tel +1 781 609 6035, Email Batool.Haider@alkermes.comPurpose: The COVID-19 pandemic substantially impacted care of patients with schizophrenia treated with long-acting injectable antipsychotics (LAIs). This study (OASIS-MAPS) examined how clinical sites adapted operations and used telepsychiatry to maintain standard of care for these patients during the pandemic.Methods: Two online surveys (initial: October–November 2020, N = 35; follow-up: July–September 2021, N = 21) were completed by a principal investigator (PI) or PI-appointed designee at sites participating in the OASIS study (NCT03919994). Survey responses were analyzed descriptively.Results: At the time of the initial survey, all 35 participating sites were using variants of telepsychiatry, with 20 sites adopting it after the pandemic started. Most sites reported no negative impacts of the pandemic on medication adherence, although approximately 20% of sites reported decreased adherence for LAIs. Twelve sites (34%) reported switching patients with schizophrenia from LAIs to oral antipsychotic medications, while 11 sites (31%) reported switching patients from shorter to longer injection interval LAIs during the pandemic. Most sites did not experience difficulties in implementing or expanding telepsychiatry services, although lower reimbursement rate for telepsychiatry and patients’ lack of access to and training on relevant technologies were the most frequently reported barriers.Conclusion: Changes made by sites after the pandemic onset were viewed by almost all participants as satisfactory for maintaining standard of care. Almost all participants thought that the use of telepsychiatry services would continue after the pandemic in a hybrid manner combining telepsychiatry and office visits. Ensuring that patients have equitable access to telepsychiatry will be important in the post-pandemic future.Keywords: telehealth, coronavirus, care management, medication adherence

BackgroundThe COVID-19 pandemic substantially impacted care of patients with schizophrenia treated with long-acting injectable antipsychotics (LAIs). This study examined how clinics adapted operations to maintain a standard of care for these patients after pandemic onset.MethodsOnline surveys were completed in October-November 2020 by one principal investigator (PI) or PI-appointed designee at 35 clinics participating in OASIS (NCT03919994). Items concerned pandemic impacts on clinic operations, particularly telepsychiatry, and on the care of patients with schizophrenia treated with LAIs.ResultsAll 35 clinics reported using telepsychiatry; 20 (57%) implemented telepsychiatry after pandemic onset. Telepsychiatry visits increased from 12%-15% to 45%-69% across outpatient visit types after pandemic onset; frequency of no-show and/or canceled telepsychiatry visits decreased by approximately one-third. Nearly half of clinics increased the frequency of telepsychiatry visits for patients with schizophrenia treated with LAIs. Approximately one-third of participants each reported switching patients treated with LAIs to longer injection interval LAIs or to oral antipsychotics. The most common system/clinic- and patient-related barrier for telepsychiatry visits was lower reimbursement rate and access to technology/reliable internet, respectively. Almost all participants (94%) were satisfied with telepsychiatry for maintaining care of patients with schizophrenia treated with LAIs; most predicted a hybrid of telepsychiatry and office visits post-pandemic.ConclusionsChanges made by clinics after pandemic onset were viewed by almost all participants as satisfactory for maintaining a standard of care for patients with schizophrenia treated with LAIs. Most participants predicted continuing telepsychiatry to support patient care post-pandemic; equitable access to telepsychiatry will be important in this regard.FundingAlkermes, Inc.