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Review
. 2021 May 24:17:1589-1597.
doi: 10.2147/NDT.S310605. eCollection 2021.

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

Richard Jackson  1 , Matthew N Brams  2 , Leslie Citrome  3 , Amber R Hoberg  4 , Stuart H Isaacson  5 , John M Kane  6 , Rajeev Kumar  7
Affiliations
Review

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

Richard Jackson et al. Neuropsychiatr Dis Treat. .

Abstract

Purpose: 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: diagnosis; functional domains; hyperkinetic movement; treatment.

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Conflict of interest statement

Richard Jackson: Conducted research for AbbVie, Avanir, Emalex, Janssen, Neurocrine, Otsuka, Purdue, and Sunovion; served as a consultant/speaker bureau participant for AbbVie, Alkermes, Janssen, Ironshore, Intracellular, Lundbeck, Noven, Otsuka, Purdue, Sunovion, Supernus, and Teva; and assisted in report writing for Cello Health Communications/MedErgy and was involved in honorarium for panel discussion that helped to develop the manuscript for Interactive Forums, Inc. Matthew N. Brams: Served as a speaker bureau participant for Intra-Cellular Therapies, Ironshore, Neos, Otsuka, and Tris Pharmaceuticals. Leslie Citrome: In the past 12 months, served as a consultant for AbbVie, Acadia, Alkermes, Allergan, Angelini, Astellas, Avanir, Axsome, BioXcel, Boehringer Ingelheim, Cadent Therapeutics, Eisai, Impel, Intra-Cellular Therapies, Janssen, Karuna, Lundbeck, Lyndra, Medavante-ProPhase, Merck, Neurocrine, Noven, Otsuka, Ovid, Relmada, Sage, Sunovion, Teva, and the University of Arizona; and provided one-off ad hoc consulting for individuals/entities conducting marketing, commercial, or scientific scoping research; served as a speaker for AbbVie, Acadia, Alkermes, Allergan, Angelini, Eisai, Intra-Cellular Therapies, Janssen, Lundbeck, Neurocrine, Noven, Otsuka, Sunovion, Takeda, Teva, and CME activities organized by medical education companies such as Medscape, NACCME, NEI, Vindico, and universities and professional organizations/societies; owns stock (small number of shares of common stock) in Bristol Myers Squibb, Eli Lilly, Johnson & Johnson, Merck, and Pfizer purchased >10 years ago; received royalties from Wiley (Editor-in-Chief, International Journal of Clinical Practice, through the end of 2019), UpToDate (reviewer), Springer Healthcare (book), Elsevier (Topic Editor, Psychiatry, Clinical Therapeutics); and reported personal fees for participating in a virtual consensus conference for Interactive Forums, Inc. and nonfinancial support for editorial/writing support for Cello Health Communications/MedErgy. Amber Hoberg: served as a speaker and/or on advisory boards for Acadia, Avanir, Intra-Cellular Therapies, and Teva. Stuart H. Isaacson: received honoraria for CME; served as a consultant or promotional speaker for or received research grants from AbbVie, Acadia, Acorda, Adamas, Addex, Affiris, Alexva, Allergan, Amarantus, Amneal, Aptinyx, Axial, Axovant, Benevolent, Biogen, Britannia, Cadent, Cala, Cerecor, Cerevel, Cipla, Eli Lilly, Enterin, GE Healthcare, Global Kinetics, Impax, Impel, Intec Pharma, Ipsen, Jazz, Kyowa, Lundbeck, Merz, Michael J. Fox Foundation, Mitsubishi Tanabe, Neuralys, Neurocrine, Neuroderm, Parkinson Study Group, Pharma2B, Prilenia, Promentis, Revance, Roche, Sanofi, Sunovion, Sun Pharma, Supernus, Teva, Theravance, and UCB; and received personal fees from Interactive Forums, Inc. (Teva) and nonfinancial support from Cello Health Communications/MedErgy. John Kane: In the past 12 months, served as a consultant to or received honoraria for lectures from Acadia, Alkermes, Allergan, Dainippon Sumitomo, Intra-Cellular Therapies, Janssen, Johnson & Johnson, LB Pharma, Lundbeck, Merck, Minerva, Neurocrine, Otsuka, Reviva, Roche, Saladex, Sunovion, Takeda, and Teva; received grants from Otsuka, Lundbeck, Sunovion, and Janssen; and is a shareholder of LB Pharma, North Shore Therapeutics, and The Vanguard Research Group. Rajeev Kumar: In the past 12 months, received honoraria for CME; served as a consultant or promotional speaker for or received research grants from AbbVie, Acadia, Acorda, Amneal, Biogen, Cala, Cerevel, Eli Lilly, Enterin, Global Kinetics, Impel, Kyowa, Mitsubishi Tanabe, Neuraly, Neurocrine, Neuroderm, Parkinson Study Group, Pharma2B, Prilenia, Revance, Roche, Sage Therapeutics, Supernus, Teva, and US World Meds. The authors report no other conflicts of interest in this work.

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