Neurology. 2025 Apr 8;104(7_Supplement_1):5023. doi: 10.1212/WNL.0000000000212081. Epub 2025 Apr 7.
ABSTRACT
OBJECTIVE: To understand patient perspectives on barriers to tardive dyskinesia (TD) diagnosis and treatment.
BACKGROUND: TD is underdiagnosed, and understanding barriers to diagnosis is an unmet need.
DESIGN/METHODS: This cross-sectional survey enrolled adults with schizophrenia, bipolar disorder, or major depressive disorder who reported symptoms suggestive of TD and current/previous antipsychotic treatment. Descriptive analysis was performed with Chi-square/Fisher’s exact test. Random forest, a machine-learning algorithm, was used to identify key factors associated with TD diagnosis and treatment. A multivariable logistic regression model with identified factors examined magnitudes and directions of associations.
RESULTS: Enrolled participants (n=327) were grouped into three cohorts, based on participant responses: 52% (n=171) had no formal TD diagnosis from a healthcare professional (HCP) (undiagnosed), 30% (n=97) were diagnosed with TD but not treated, and 18% (n=59) were diagnosed and currently/previously treated. Fewer participants in undiagnosed versus diagnosed cohorts discussed involuntary movements with HCPs (P<.0001) or were physically examined for TD (P<.0001). Participants who discussed involuntary movements with HCPs were more often diagnosed than those who did not (odds ratio, 31.92 [95% CI, 14.73-76.09]; P<0.01). Undiagnosed participants more commonly reported low income (P=.0001) and low levels of employment (P=.0003). Participants were less likely to be diagnosed if they sometimes (0.33 [0.14-0.74]; P=0.01) or often (0.28 [0.11-0.72]; P=0.01) struggled with food/money. Treated participants reported more common HCP engagement (appointments within the last 3 months) (P=.0001) than TD-diagnosed but untreated participants, and participants who commonly engaged were more likely to receive TD treatment than those who did not (9.01 [3.08-33.79]; P<0.01).
CONCLUSIONS: Lack of discussion of TD symptoms with HCPs and low socioeconomic status were barriers to TD diagnosis. Infrequent HCP visits was a barrier to treatment. These results highlight the need for increased patient education and for HCPs to proactively discuss TD symptoms with patients. Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff. Disclosure: Ms. Solis has received personal compensation for serving as an employee of Teva Pharmaceuticals. Nayla Chaijale has received personal compensation for serving as an employee of Teva Pharmaceuticals. Ms. Gonzalez has received personal compensation for serving as an employee of Teva Pharmaceuticals. Ms. Gonzalez has received personal compensation for serving as an employee of Teva Pharmaceuticals. Ms. Gonzalez has stock in Teva Pharmaceuticals. Dr. Zhang has received personal compensation for serving as an employee of Teva. Dr. Zhang has stock in Teva. Mr. Ahn has nothing to disclose. Ms. Luo has received personal compensation for serving as an employee of TechData Service, Inc.. Ms. Overbaugh has received personal compensation for serving as an employee of Research Catalyst, LLC. Dr. Suett has received personal compensation for serving as an employee of Teva. Dr. Suett has stock in Teva. Dr. Tian has received personal compensation for serving as an employee of Teva Pharmaceuticals. Dr. Tian has stock in Teva Pharmaceuticals. Dr. Ramirez Campos has received personal compensation for serving as an employee of teva. The institution of Dr. Kumar has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Supernus. The institution of Dr. Kumar has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. The institution of Dr. Kumar has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Teva Pharmaceuticals. The institution of Dr. Kumar has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Annexon. The institution of Dr. Kumar has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. The institution of Dr. Kumar has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Acorda Therapeutics. The institution of Dr. Kumar has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Cerevel Therapeutics. Dr. Kumar has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Cerevance. The institution of Dr. Kumar has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Ferrer. Dr. Kumar has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Supernus. The institution of Dr. Kumar has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for Teva. The institution of Dr. Kumar has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Kyowa Kirin. Dr. Kumar has received personal compensation in the range of $1,000,000+ for serving as an officer or member of the Board of Directors for Research Catalyst, LLC. Dr. Kumar has received personal compensation in the range of $100,000-$499,999 for serving as an officer or member of the Board of Directors for CenExel RMCR. Dr. Kumar has stock in Research Catalyst, LLC. Dr. Kumar has stock in CenExel. Dr. Kumar has stock in Neurofold Therapeutics. The institution of Dr. Kumar has received research support from Supernus. The institution of Dr. Kumar has received research support from Sage Therapeutics. The institution of Dr. Kumar has received research support from Prilenia Therapeutics. The institution of Dr. Kumar has received research support from Roche. The institution of Dr. Kumar has received research support from Triplet Therapeutics. The institution of Dr. Kumar has received research support from CHDI Foundation. The institution of Dr. Kumar has received research support from Neurocrine Biosciences. The institution of Dr. Kumar has received research support from Biovie. The institution of Dr. Kumar has received research support from Neuroderm. The institution of Dr. Kumar has received research support from Sanofi. The institution of Dr. Kumar has received research support from Addex Pharma. The institution of Dr. Kumar has received research support from Integrative Research Laboratories. The institution of Dr. Kumar has received research support from Takeda Pharmaceuticals. The institution of Dr. Kumar has received research support from Neuraly. The institution of Dr. Kumar has received research support from Abbvie. The institution of Dr. Kumar has received research support from Cerevel Therapeutics. The institution of Dr. Kumar has received research support from Transposon Therapeutics. The institution of Dr. Kumar has received research support from Lundbeck. The institution of Dr. Kumar has received research support from Biohaven. The institution of Dr. Kumar has received research support from Revance Therapeutics. The institution of Dr. Kumar has received research support from Impax Laboratories. The institution of Dr. Kumar has received research support from CND Life Sciences. The institution of Dr. Kumar has received research support from Neuron23. The institution of Dr. Kumar has received research support from Annexon Biosciences. The institution of Dr. Kumar has received research support from Annovis. The institution of Dr. Kumar has received research support from PTC Therapeutics. The institution of Dr. Kumar has received research support from Uniqure. The institution of Dr. Kumar has received research support from Alexza. The institution of Dr. Kumar has received research support from SparkNeuro. The institution of Dr. Kumar has received research support from Praxis. The institution of Dr. Kumar has received research support from Scion Neurostim. The institution of Dr. Kumar has received research support from Cognition Therapeutics. The institution of Dr. Kumar has received research support from Eli Lilly. The institution of Dr. Kumar has received research support from Aribio. The institution of Dr. Kumar has received research support from Biogen. The institution of Dr. Kumar has received research support from Bial R and D investments. The institution of Dr. Kumar has received research support from Ono Pharmaceutical Company. The institution of Dr. Kumar has received research support from UCB Biopharma. The institution of Dr. Kumar has received research support from Vigil Therapeutics. Dr. Kumar has received personal compensation in the range of $100,000-$499,999 for serving as a Medical Director with CenExel RMCR. Dr. Kumar has received personal compensation in the range of $1,000,000+ for serving as a Managing Member with Research Catalyst, LLC. Dr. Kumar has a non-compensated relationship as a Board Member with Movement Disorders Foundation that is relevant to AAN interests or activities.
PMID:40194136 | DOI:10.1212/WNL.0000000000212081
Recent Comments