hardLAIaripiprazole lauroxiladherenceschizophreniashared decision-makingBPRSrelapse prevention
A 29-year-old male with schizophrenia was transitioned from oral aripiprazole 20 mg daily to aripiprazole lauroxil 882 mg intramuscular every six weeks after two psychiatric hospitalizations attributed to medication nonadherence over the past year. He has received four injections and is presenting for his fifth injection. His BPRS score has decreased from 48 to 28 over the five-month treatment period. He reports improved clarity of thinking and has re-enrolled in a vocational training program. However, his case manager reports he has missed two of his last three scheduled injection appointments, requiring rescheduling and home-visit administration. At today's visit, he is nine days past his scheduled injection date. He states the injections are painful and inconvenient, and he is requesting to return to oral medication because he feels well enough to manage his own pills. The PMHNP is evaluating the treatment adherence pattern and the appropriateness of this request. Which of the following best represents the appropriate evaluation?