Assessment of the Impact of Tardive Dyskinesia in Clinical Practice: Consensus Panel Recommendations

Abstract

Richard Jackson,1 Matthew N Brams,2 Leslie Citrome,3 Amber R Hoberg,4 Stuart H Isaacson,5 John M Kane,6 Rajeev Kumar7 1University of Michigan School of Medicine, Ann Arbor, MI, USA; 2Baylor College of Medicine, Houston, TX, USA; 3New York Medical College, Valhalla, NY, USA; 4GeroPsych Associates of Central Texas, Austin, TX, USA; 5Parkinson’s Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL, USA; 6Feinstein Institution for Medical Research, Lynbrook, NY, USA; 7Rocky Mountain Movement Disorders Center, Englewood, CO, USACorrespondence: Richard JacksonUniversity of Michigan School of Medicine, 4111 Andover Road, Suite W100, Bloomfield Hills, MI, 48302, USATel [phone]Fax [phone]Email [email protected]: Tardive dyskinesia (TD) is a hyperkinetic movement disorder in which patients experience abnormal involuntary movements that can have profound negative impacts on physical, cognitive, and psychosocial functioning. Use of measures to assess the functional impact of TD in routine clinical practice is lacking. To address this gap, an advisory panel of experts in psychiatry and movement disorder neurology was convened to develop consensus recommendations on assessment of the impact of TD on patients’ functioning that can be used in clinical practice.Methods: An advisory panel provided recommendations using an iterative process, beginning with a narrative literature review regarding current practices for assessing the impact of TD in clinical settings. A detailed summary was generated, and the advisory panel provided comments about the content and answered questions about assessing TD impact in clinical practice. The panelists’ responses were discussed during a virtual meeting held on August 28, 2020. A second meeting on September 25, 2020, focused on developing and refining recommendations for assessment of the impact of TD in clinical practice. At the conclusion of the second meeting, general consensus was reached on all recommendation statements.Results: As part of routine clinical practice, it is imperative to assess the impact of TD on the patient’s life to help guide treatment decisions. Key domains for assessing the overall impact of TD include social, physical, vocational, and psychological functioning and the impact of TD on the underlying psychiatric disorder. Assessment of TD impact should be performed at every patient visit. Impact assessments should include consultation with patients, caregivers, and family members. Shared decision-making to initiate TD treatment should consider impact.Conclusion: The impact of TD should be assessed routinely, including the key domains of social, physical, vocational, and psychological functioning and the impact of TD on the underlying psychiatric disorder.Keywords: hyperkinetic movement, functional domains, diagnosis, treatment

Keywords

• hyperkinetic movement
• functional domains
• diagnosis
• treatment