Online Survey Reveals Clinicians’ Top Concerns in BDI, Schizophrenia Treatment

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Findings from a recent online research study by The Harris Poll indicated that clinicians are concerned about their patients’ quality of life as well as medications issues like adherence and switching. Specifically, researchers discovered that the quality of life in patients with schizophrenia was significantly lower than patients with bipolar I disorder (BDI), health care professionals are worried about their patients not staying medicated, and more concerns regarding switching medications for patients. Health care professionals also often prioritized approaches that aid long-term symptom control, treatment consistency, and quality of life considerations in patients with schizophrenia or bipolar I disorder (BD1).¹ Supported by Alkeremes, the study collected responses from 127 psychiatrists and 126 nurse practitioners/physician assistants who saw at least 10 BD1 patients and at least 2 schizophrenia patients per month.

The study highlighted the differences between the clinicians concerns for patients with schizophrenia as compared with patients with BDI, including symptom control and quality of life in patients, as well anxieties caused by medication adherence and the impact of medication switching.

Of the health care professionals surveyed, 66% believed patients with BDI have good or excellent overall quality of life, but only 21% felt their patients with schizophrenia had the same overall quality of life. However, 77% of respondents agreed that switching medications frequently can have negative effects on patients’ quality of life, while 76% of respondents said switching medications also made it more difficult for patients to maintain control of symptoms over time.

The study also reported the top 3 concerns providers shared about their patients with BDI. 36% of providers included the ability of patients to stay medicated long-term, 32% of providers said the frequency of manic symptoms or episodes patients experience, and 31% of providers said the frequency of depressive symptoms or episodes patients experience. Among patients with schizophrenia, providers shared the top three concerns were the ability of patients to take their prescribed medication (42%), the ability of patients to stay medicated long-term (41%), and the patients’ ability to be independent and complete daily activities (38%).

Other findings from the study revolved around medication switching, with providers reporting that patients with BDI having to switch medications an average of 7 times throughout their lives and patients with schizophrenia having to do so an average of 8 times throughout their lives. The switching of medication also causes concern for negative effects to occur, as 77% of providers agreed that frequently switching medications can drastically change a patient’s quality of life, making it more difficult to maintain control of symptoms overtime.

Additionally, health care providers tended to make more calculated decisions when offering new treatments, taking into account clinical guidelines, accessibility, and individual patient circumstances. When discussing patient outcomes, providers also reported weighing a variety of clinical and individual considerations, emphasizing the importance of using different measures of treatment efficacy.

In a previously published article discussing a team-driven approach for schizophrenia treatment, Tracy Hicks, DNP, FNP/PMHNP-BC, said open communication is crucial to successful patient outcomes. “Regular assessments of treatment efficacy are essential to see if adjustments are necessary,” said Hicks.² “Therapeutic drug monitoring allows us to objectively measure the drug's presence in the body and adjust as needed. This aids in ensuring adherence and also strengthens the patient's trust in the treatment process. Knowing that the patient receives consistent dosing with an LAI, we can more easily monitor whether the medication works effectively and iterate accordingly.”

To providers, the most important outcomes for patients included experiencing symptoms of their disease less frequently, being able to remain independent and complete daily tasks, and being able to stay on medication long-term.¹ Overall, 98% of providers said improving quality of life mattered just as much as managing symptoms in patients.

"The perspectives of healthcare providers captured in this survey are valuable in helping to understand the path that patients may navigate following a schizophrenia or bipolar I disorder diagnosis,” said Kanchan Relwani, MD, senior vice president, medical affairs at Alkeremes, in a press release. “These insights help inform and characterize the barriers and opportunities that exist to advance care."¹ 

References

1. New National Survey of Healthcare Providers Offers Insights Into the Dynamic and Challenging Treatment Journey for People Living With Schizophrenia or Bipolar I Disorder. News release. March 31, 2025. https://www.prnewswire.com/news-releases/new-national-survey-of-healthcare-providers-offers-insights-into-the-dynamic-and-challenging-treatment-journey-for-people-living-with-schizophrenia-or-bipolar-i-disorder-302412777.html

2. Hicks T. Long-Acting Injectables and a Team-Driven Approach for Schizophrenia Treatment. Psychiatric Times. November 18, 2024. https://www.psychiatrictimes.com/view/long-acting-injectables-and-a-team-driven-approach-for-schizophrenia-treatment