This poster was presented at the 30th annual Psych Congress, held Sept. 16-19, 2017, in New Orleans, Louisiana.
Introduction: Tardive dyskinesia (TD) is an involuntary movement disorder associated with long-term antipsychotic use. There is little consensus regarding optimal treatment for TD, and management remains a significant challenge. Continuing Medical Education (CME) is a valuable tool for increasing physician knowledge and performance, but CME programs must be targeted to the greatest area of need to produce the most robust impact. To date, there are no data available regarding psychiatrists' practice patterns related to TD to guide development of CME programs.
Methods: This study utilized an online, case-vignette survey to quantify psychiatrists' TD practice patterns and identify opportunities for future CME programming. Case-vignette surveys are a validated, comprehensive means of assessing physician practice patterns. The survey included two cases with TD: a 72-year-old woman using escitalopram, mirtazapine, and adjunctive aripiprazole for depression; and a 25-year-old man using haloperidol and lurasidone for schizoaffective disorder. Both cases were followed by a series of questions to elucidate management approaches employed by psychiatrists.
Results: Invitations to the online survey were distributed via email and responses were collected from 100 US-practicing psychiatrists. Most psychiatrists included antipsychotic dose reduction, discontinuation or switching as part of their initial management strategy despite limited evidence; however, there was virtually no consensus on subsequent steps, including the use of vesicular monoamine transporter-2 inhibitors.
Conclusions: Psychiatrists may benefit from additional education regarding evidence-based management strategies for patients with TD. This is especially important in relation to the integration of new treatments of TD within the context of ongoing psychopharmacological therapy.