High Comorbidity, Polypharmacy Burden in Patients With Tardive Dyskinesia in LTC Settings

Patients with tardive dyskinesia (TD) in long-term care (LTC) settings have a high comorbidity and polypharmacy burden, with almost half taking medications that can actually worsen TD, according to a poster presentation at the American Psychiatric Association Annual Meeting in New York, New York.

Poster author Amita R. Patel, MD, Dayton Psychiatric Associates, Ohio, analyzed real-world data for 2294 patients with TD who had a LTC stay between 2017 and 2021. Nearly two-thirds of the patients were 65 years or older.

According to the analysis, patients had an average Charlson Comorbidity Index score of 3.72. A third had a score of 4 or higher. 

Mood disorders were prevalent, affecting 66.1% of patients, the study found. Schizophrenia (38.8%) and sleep disorders (35%) were also common. Additional comorbidities of interest included substance abuse (28.4%), urinary tract infection (26.7%), and dysphagia (18.5%).

More than half of patients were prescribed antidepressants (56.1%), antipsychotics (50.4%), anticonvulsants (52.3%), and anticholinergics (50%). Almost half (47.9%) of patients were taking 3 or more central nervous system medications.

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Within a year of their initial LTC stay, 47.3% patients had 1 or more emergency department visits. The median number of emergency department visits per patient was 4, and the median time to the first emergency department visit was 143 days after the initial LTC stay. 

“Analysis of real-world claims data indicated that patients with TD in LTC settings had high comorbidity burden and polypharmacy with medications that frequently induce TD (antipsychotics) or worsen TD (anticholinergics). Moreover nearly 50% of patients had at least 1 emergency department visit within 1 year of the post-index LTC stay,” Dr Patel wrote. “These data indicate a need for special attention to the needs and pharmacological treatments in older adults with TD.”

The study was supported by Neurocrine Biosciences Inc.

Reference

Patel A. The burden and characteristics of diagnosed tardive dyskinesia in long-term care settings. Poster presented at the American Psychiatric Association Annual Meeting; May 4-8, 2024; New York, New York