Impact-Tardive Dyskinesia (Impact-TD) Scale

Jackson, Richard F. W.; Brams, Matthew; Carlozzi, Noelle E.; Citrome, Leslie; Fritz, Nora; Hoberg, Amber R.; Isaacson, Stuart; Kane, John M.; Kumar, Rajeev

doi:10.4088/jcp.22cs14563

Cited by 5 publications

(2 citation statements)

References 13 publications

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“…The majority of their TD patients (60-100%) had a documented history of APD use and 0-40% had a documented history of the other DRBA use.In the experts'opinion, a high proportion of patients (30-80%) feel that their condition has a significant negative impact on their daily lives, including their physical, cognitive, and psychosocial functioning, and that this increases in line withduration of APD exposure, duration of symptoms, age, and occupation. This aligns with a recent survey undertaken in the US which found that TD imposes a substantial burden on patients' physical, psychological, social, and professional lives and impacts management of their underlying psychotic condition [15].Consensus recommendations now suggest that the impact of TD should be assessed routinely in clinical care, particularly the key domains ofsocial, physical, vocational, and psychological functioning [16].The experts suggested that trackingpatients' APD exposure over time would be useful,but would be a challenge in clinical practice sincemany are unaware of what particular drugs they are taking, and clinicians may not keep a good history, or may be using them off-label.In the experts' clinical experience, patients are oftenunaware that the drugs they are taking may contribute to abnormal movements, assuming they are part of their underlying condition, so may not report them.…”

supporting

confidence: 71%

Neurological Perspectives Should Be Integrated Into the Management of Tardive Dyskinesia—Expert Opinions and Proposed Educational Initiatives in Asia

Bhidayasiri,

Phokaewvarangkul,

Lim

et al. 2024

JMD

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227Tardive dyskinesia(TD) is a movement disorder that exhibits a range of clinical manifestations arising as side effects of treatment with dopamine receptor-blocking agents, primarily antipsychotic drugs (APDs) [1,2].Consequently,its management overlaps different disciplines, in particular, psychiatry and neurology.In practice, this canresult ina gap in management whereby patients receive only one aspect of what should ideally bemultidisciplinarycare. Psychiatrists will naturally focus on controllingthe patient'schallenging psychotic symptomsand may not be specialized in the evaluation of the abnormal movements that are a core manifestation of TD [3,4].As a result, exposure of neurologists to TD patients may be limited to when the condition has becomesevere. Indirect evidence of this is suggested by the psychiatry curriculum for neurology residents developed in collaboration with the Consortium of Neurology Program Directors and the American Association of Directors of Psychiatric Residency Training, approved by the American Academy of Neurology's (AAN)

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supporting

confidence: 71%

Neurological Perspectives Should Be Integrated Into the Management of Tardive Dyskinesia—Expert Opinions and Proposed Educational Initiatives in Asia

Bhidayasiri,

Phokaewvarangkul,

Lim

et al. 2024

JMD

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“…Another US study found that implementing a 1-h training course for clinicians regarding AIMS screening for TD significantly improved the use of the tool and subsequent documentation in patients' records ( 113 ). Recognizing that the impact of TD may not always depend solely on the severity of TD symptoms, a new rating scale—Impact-TD—has been developed to assess the impact of the condition on patients' daily functioning which can be implemented easily in a clinical practice setting to provide further insights for the clinician ( 114 ). Although telehealth is something that is becoming increasingly used in many fields of medicine, a report from panel of experts comprising both neurologists and psychiatrists, conclude that while it was a useful adjunctive tool for the assessment of TD, it was not an adequate substitute for in-person assessment ( 115 ).…”

Section: Strategies For Minimizing and Managing Tdmentioning

confidence: 99%

Tardive dyskinesia in Asia— current clinical practice and the role of neurologists in the care pathway

Bhidayasiri,

Phokaewvarangkul,

Shang

et al. 2024

Front. Neurol.

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Tardive dyskinesia (TD) is a movement disorder that can arise as a side effect of treatment with dopamine receptor-blocking agents (DRBAs), including antipsychotic drugs (APDs) used to manage psychotic illnesses. Second-generation APDs (SGAs) are often preferred to first-generation drugs due to their lower propensity to cause TD, however many SGAs-treated patients still develop the condition. Although TD is a global health concern, evidence regarding the occurrence of TD and how it is managed in Asian countries is currently limited. This article reports the results of a systematic review of the published literature on TD focusing on its prevalence, types of patients, knowledge of the condition, causative factors, and usual treatment pathways in clinical practice in Asian countries. Epidemiological data suggest that the prevalence of TD is increasing globally due to an overall rise in APD use, contributing factors being polypharmacy with multiple APDs, the use of higher than necessary doses, and off-label use for non-psychotic indications. Although exact prevalence figures for TD in Asian countries are difficult to define, there is a similar pattern of rising APD use which will result in increasing numbers of TD patients in this region. These issues need to be addressed and strategies developed to minimize TD risk and manage this disabling condition which impacts patients' quality of life and daily functioning. To date, both research into TD has been predominantly psychiatry focused and the perspectives from neurologists regarding the clinical management of this challenging condition are scarce. However, neurologists have an essential role in managing the movement disorders manifestations that characterize TD. Optimum management of TD, therefore, should ideally involve collaboration between psychiatrists and neurologists in joint care pathways, wherever practical. Collaborative pathways are proposed in this article, and the challenges that will need to be addressed in Asian countries to improve the care of people with TD are highlighted, with a focus on the neurologist's viewpoint and the implications for the management of TD globally.

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Consensus panel recommendations for the optimization of EPIDIOLEX® treatment for seizures associated with Lennox–Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex

Wechsler,

Burdette,

Gidal

et al. 2024

Epilepsia Open

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Following the approval of Epidiolex® (cannabidiol; CBD) for the treatment of seizures associated with Lennox–Gastaut syndrome (LGS), Dravet syndrome (DS), and tuberous sclerosis complex (TSC), healthcare professionals (HCPs) have had substantial experience in treating patients with Epidiolex. However, confusion still remains among HCPs, caregivers, and patients regarding dosing, drug interactions, safety monitoring, and differentiation between Epidiolex and nonapproved CBD products. To establish consensus recommendations for Epidiolex treatment optimization in LGS, DS, and TSC, a panel of seven HCPs with expertise in epilepsy was convened. Panelists participated in a premeeting survey based on a literature review of Epidiolex for the treatment of LGS, DS, and TSC, and survey responses were compiled for discussion. A modified Delphi method was used to assess agreement among panelists regarding recommendation statements following two rounds of discussion. Panelists identified two broad themes – overcoming barriers to initiation and optimization of treatment for seizures associated with LGS, DS, and TSC – for consensus guidelines. Accurate identification of patients with these rare epilepsies is critical for optimization of Epidiolex treatment. Providers should differentiate Epidiolex from nonapproved CBD products and set expectations for the therapeutic effect and safety/tolerability of Epidiolex. Initial target dose and titration rate should be individualized by baseline variables, prior response to antiseizure medications, and therapeutic goals. Awareness of strategies to manage adverse events and concomitant medications, including drug–drug interactions, is critical. Tracking response to the maximum tolerated dose is an important measure of effectiveness. These consensus recommendations provide real‐world experience from neurology HCPs with experience in prescribing Epidiolex and can inform optimal use of Epidiolex for the treatment of seizures associated with LGS, DS, and TSC.Plain language summaryEpidiolex® (cannabidiol) is approved for treating seizures in Lennox–Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex. Although healthcare professionals have experience in treating patients with Epidiolex, there is a need for better understanding of dosing, drug interactions, and safety of this drug. Therefore, a group of epilepsy experts developed guidelines for best practices in Epidiolex treatment. Two main areas were identified: overcoming barriers to starting Epidiolex and considerations related to Epidiolex dosing. Within these areas, topics, including correct disease identification, managing adverse events, and determining individualized dose, were discussed. These guidelines provide real‐world experience to inform optimal Epidiolex use.

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Impact-Tardive Dyskinesia (Impact-TD) Scale

Cited by 5 publications

References 13 publications

Neurological Perspectives Should Be Integrated Into the Management of Tardive Dyskinesia—Expert Opinions and Proposed Educational Initiatives in Asia

Neurological Perspectives Should Be Integrated Into the Management of Tardive Dyskinesia—Expert Opinions and Proposed Educational Initiatives in Asia

Tardive dyskinesia in Asia— current clinical practice and the role of neurologists in the care pathway

Consensus panel recommendations for the optimization of EPIDIOLEX® treatment for seizures associated with Lennox–Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex

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