Overcoming barriers to treatment for people with schizophrenia

Addressing gaps in patient care: A case study in Tennessee

Pharmacists at Genoa’s pharmacies, which serve people experiencing behavioral health and other complex health conditions, work closely with providers to make long-acting injectables (LAIs) part of outpatient care. This helps patients stay on track with their treatment.

The challenge: After LAI patients were discharged from a hospital in Chattanooga, Tennessee, they failed to continue therapy, mainly due to access issues. For example, patients may have started a specific LAI during hospitalization; however, following discharge, many encountered barriers to accessing the same medication or disengaged from care entirely, resulting in loss of follow-up.

As a result, the patients missed doses or ended up back in the hospital.

The solution: Genoa pharmacists partnered with the hospital to offer patients the option of receiving their medications through Genoa. Once patients received their first dose of an LAI from the Genoa pharmacy, the pharmacy team began working to confirm coverage, handled prior authorizations, and enrolled patients in assistance programs if necessary – all while patients were still under hospital care.

For ongoing LAI treatments, patients could come back to the pharmacy for their next LAI dose, plus receive medication counseling and support throughout the entirety of the treatment process. Genoa also provided education, refill reminders and close coordination with care teams to help patients stay on their medications and out of the hospital.

“Genoa’s proactive approach allowed patients to continue their therapy without interruption while they transitioned out of the hospital, reducing the likelihood of readmissions and leading to a better quality of life,” said Blake Shoemaker, senior manager of pharmacy product at Genoa, who spearheaded the initiative in Tennessee which later led to a full-scale LAI program.

The role of long-acting injectables (LAIs) in treating schizophrenia

Research has shown that administering LAIs to patients with schizophrenia provides consistent medication delivery, reducing the risk of a relapse, and supporting better long-term health outcomes². One LAI injection can last at least 30 days – a crucial window to transition patients to another care setting if they start the LAI in the hospital, according to Genoa. LAIs have a significant advantage over oral medications, where adherence can be unpredictable because patients must remember to take their medication every day. Research has also linked LAIs to improved adherence and reduced hospitalizations compared with oral therapies³.

American Journal of Managed Care

Part 1 Case Study: Profiles in Care: Optimizing Long-Acting Injectable (LAI) Administration for Patients Living With Schizophrenia

Part 2 Case Study: Long-Acting Injectable (LAI) Program Implementation Insights From Genoa Healthcare® Pharmacy

Genoa administered more than 200 LAIs in the first year of the program in 2022. By March 2025, the number had grown to over 860, an increase of more than 400%, highlighting the program’s success and growing role in supporting long-term treatment adherence⁴.

Genoa’s pharmacist-led LAI program

Genoa’s LAI program, led by pharmacists, addresses the challenges of medication adherence and care transitions for patients with schizophrenia and severe mental health conditions by providing clinical support in a safe and convenient location. Where state laws allow, Genoa pharmacists fill and administer LAIs, making the process as simple as possible for the patient. The program has been successfully implemented across hundreds of pharmacies in more than 45 states, particularly in underserved areas, emphasizing the importance of seamless care transitions and proactive patient support.