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A 30-year-old man with schizophrenia has been hospitalized three times in the past two years, each time following medication discontinuation. During each hospitalization, he responded well to risperidone oral tablets, achieving remission of psychotic symptoms within three to four weeks. However, within two to three months of discharge, he stops taking his oral medication, citing forgetfulness, feeling that he no longer needs it once symptoms resolve, and disliking the daily reminder of his illness. He has a supportive family, attends follow-up appointments consistently, and has good insight into his diagnosis when stable. He is currently nearing discharge after his most recent hospitalization and is again responding well to oral risperidone. The PMHNP is developing a discharge plan to address the recurring non-adherence pattern. Which of the following best represents the most appropriate treatment planning strategy?
Explanation
For patients with schizophrenia who demonstrate a recurring pattern of non-adherence to oral antipsychotics leading to relapse and rehospitalization, transitioning to a long-acting injectable formulation is the evidence-based strategy that directly addresses the adherence barrier while maintaining therapeutic efficacy.
Key Takeaway
Long-acting injectable antipsychotics are the preferred strategy for schizophrenia patients with documented patterns of oral medication non-adherence and recurrent relapse, as they eliminate the need for daily medication decisions while maintaining pharmacological efficacy.