Objective: This study sought to understand evolving continuing medical education (CME) needs of US physicians managing patients with tardive dyskinesia (TD) by assessing the knowledge, practice, and barriers at three timepoints since 2018.

Background: TD is a persistent and potentially disabling movement disorder associated with prolonged exposure to antipsychotics and other dopamine-receptor blocking agents.

Method: A case-based survey was developed in 2018, and updated in 2020 and 2021, to assess practice, knowledge, and attitudes of US-practicing psychiatrists (psychs) and neurologists (neuros) in the managing patients with TD. The surveys were fielded in May 2018, March 2020, and December 2021.

Results: Survey respondents (N = 400 in 2018, N = 253 in 2020, N = 202 in 2021) included psychs, neuros, and a subset of movement disorder specialists (MDSs). Of these respondents, 75 completed surveys at all three timepoints; the other responders varied over time. Respondents continue to underestimate the prevalence of TD (45% psychs, 35% neuros [2021]). When assessing patients with TD, most psychs (83%) reported using the Abnormal Involuntary Movement Score (AIMS), vs 35% and 9% for MDSs and general neuros, respectively.

Since 2020, more respondents are including pharmacologic therapy as part of initial management for patients with TD and opting for a VMAT2 inhibitor to manage TD symptoms that persist despite adjustment to the patient’s antipsychotic. MDSs were more likely than general neuros to use a VMAT2 inhibitor. Almost half (46%) of the neuros that would not opt to treat a patient with TD with a VMAT2 inhibitor reported it was due to lack of familiarity with VMAT2 inhibitors, while the majority of psychs reported they would not use a VMAT2 inhibitor due to cost. Respondents reported the most common patient complaints prompting treatment for TD are patient embarrassment and effect on quality of life. Further the most significant barrier to optimal management of TD continues to be maintaining control of the underlying psychiatric disorder.

Conclusion: These findings demonstrate that management of patients with TD has shifted over time, with continuing education contributing to these shifts. Additional education is needed on supportive evidence of best approaches to managing TD symptoms while maintaining control of the underlying psychiatric disorder.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/trending-the-educational-needs-of-us-physicians-related-to-managing-patients-with-tardive-dyskinesia/