Tardive dyskinesia has significant burden on patient quality of life, worsening the development and treatment of underlying psychiatric conditions
Presenter: Rinat Ribalov, BSc Pharm, Teva Pharmaceuticals Industries Ltd, Tel Aviv, Israel
Burden and management of tardive dyskinesia (TD): a cross-sectional international survey study to assess the perceptions and experiences of patients with TD. Abstract 1918. Presented August 30, 2023.
An online survey of 435 patients with tardive dyskinesia (TD) revealed that TD negatively affects their quality of life across psychological, social, physical, and occupational domains, in addition to significant impairment of work and activity.
Overall, nearly half (47%) of the patients reported that TD always or often affected the development of additional psychiatric conditions (eg, anxiety), 29% reported that their adherence with treatment for their underlying psychiatric condition was affected by TD, and 25% reported worsening of their underlying psychiatric condition because of TD. Further, 76% of physicians who responded to their own survey reported a moderate to very strong impact of TD on worsening adherence with treatment for the underlying condition, underlying psychiatric condition symptoms (71%), and development of other psychiatric symptoms (78%). Physicians also reported that the most common reasons for initiating TD-specific treatment were the impact of TD on patient quality of life (reported by 93% of physicians), activities of daily living and physical functioning (reported by 88%), and social functioning (reported by 76%).
“Both patients and physicians agreed that TD has a substantial impact on patient quality of life. These results indicate that TD could undermine psychiatric stability by worsening underlying psychiatric conditions and treatment adherence,” wrote the investigators, led by Rinat Ribalov, BSc Pharm, Teva Pharmaceuticals Industries Ltd, Tel Aviv, Israel.
The 20-minute online survey included patients at least 18 years old from Australia (n = 100), Brazil (n = 85), China (n = 150), and South Korea (n = 100) who self-reported a physician diagnosis of TD, experienced extra, irregular movements, and had a diagnosis of schizophrenia or schizoaffective disorder, bipolar disorder, or major depressive disorder. Patients were recruited via online panels, social media, or physician referral. Patients were asked to rate the impact of TD on psychological, social (eg, participation in social activities), and physical domains, rated from 1 (least impact) to 5 (most impact). Approximately 54% of respondents reported a diagnosis of schizophrenia or schizoaffective disorder, 47% bipolar disorder, and 39% major depressive disorder.
Certified neurologists and psychiatrists were invited via panels to participate in a separate 20-minute online survey. A total of 340 physicians responded: 61% were psychiatrists and 39% neurologists. Their mean post-qualifying clinical experience was 15.6 years, and 86% of their time was spent in direct patient care.
The impact on overall activities and work productivity was assessed using the Work Productivity and Activity Impairment Questionnaire (WPAI), including questions on percentage of work time missed, percentage of impairment while working, percentage of overall work impairment, and percentage of overall activity impairment. The WPAI was assessed for working patients and by type of underlying psychiatric disorder. Certified neurologists and psychiatrists were invited via panels to participate in a separate 20-minute online survey.
Patients reported the greatest mean impact of TD on the psychological domain (mean score, 3.36), followed by social (2.84), and physical (2.51) domains. Of the 187 patients who were currently working, 15% reported absenteeism, 60% reported overall impairment while working, and 59% reported impairment of activity.
Patients also reported that TD symptoms had a negative impact on their quality of life for the past 7 days: 54% always or often felt sad or unhappy and 59% always or often felt anxious or worried. Approximately 41% of patients always or often limited their social activities because of TD, and 37% reported that TD impacted their ability to enjoy fun activities. More than 80% of patients and physicians indicated that TD had a moderate to strong impact on quality of life; 63% of patients reported a strong impact on their quality of life compared with 46% of physicians.
The results indicate that TD could undermine psychiatric stability by worsening underlying psychiatric conditions and treatment adherence, according to the researchers.
Disclosures
The study was supported by funding from Teva Branded Pharmaceutical Products R&D, Inc.
Several co-authors are employees and/or shareholders of Teva Pharmaceuticals and several others are employees of Cerner Envia, which has received payments from Teva Pharmaceutical Industries in relation to the study.