Commentary: Experiences and perceptions of patients, caregivers, and healthcare professionals with long-acting injectable antipsychotics for the treatment of schizophrenia: qualitative results from the multinational ADVANCE study

The "Missing Link" in Decision-Making Triads 28 A pivotal limitation acknowledged by the authors is that the patient, caregiver, and HCP cohorts 29were not linked and were recruited as disjointed groups. In the clinical practice of schizophrenia 30 treatment, the decision to initiate LAI involves a dynamic interaction within this specific triad. 31Without linked data, it becomes difficult to accurately assess the "discordance" mentioned in the 32 study. For example, when physicians cite "patient aversion to injections" as a primary barrier, is this 33 an accurate reflection of their patients' views, or is it a paternalistic assumption that preemptively 34 shuts down the conversation? In disjointed samples, we could not verify whether a patient's refusal 35 correlated with their specific physician's communication style or the caregiver's stance. 36Understanding the true mechanics of shared decision making requires a study design that analyzes 37 these three perspectives as a single interacting unit. 38 4