Discussing Virtual, Hybrid, and In-Person TD Treatment Models

Tardive dyskinesia is a complex disease state, one that often leaves providers wondering what the best plan of action is. For those who practice psychiatry in hybrid and fully-remote settings, even more considerations are at play when screening for, diagnosis, and treating TD.

Psych Congress Network sat down with Desiree Matthews, PMHNP-BC, at Psych Congress NP Institute 2023 to ask about her clinical experience using telehealth to treat tardive dyskinesia. Matthews provides an overview of what clinicians can expect when encountering TD in-person as well as in hybrid and telehealth models, and details to keep in mind when deciding upon the best treatment plan for each patient.

For more expert insights on tardive dyskinesia, visit our TD Excellence Forum.

Save the date for NP Institute, March 20-23, 2024 in San Diego, California! For more information, visit the meeting website.

Read the Transcript:

Desiree Matthews, PMHNP-BC: Hello, my name is Desiree Matthews, and I'm a psychiatric nurse practitioner. I work in a community mental health center out of Charlotte, North Carolina.

So when you're considering your practice, some practices are a hybrid model where patients will come to the office and they'll also do telehealth visits. For most patients, I would say that telehealth with video—if it's adequate, it's clear, great lighting, the video's not choppy—I  would say those patients that are at risk of tardive dyskinesia, I would say many of my patients are very comfortable with using telehealth only as am I. I can complete the AIMS via telehealth. I'm able to inspect head to toe. I can see their toes, I can see the inside of their mouth. The video is very clear for those patients that have adequate bandwidth, and internet, and camera quality.

For patients that maybe lack some of these resources potentially or that prefer in-person visits, those are patients that I would certainly consider for a hybrid model of care, where I may see them every so often from their own home via telehealth., and then every 6 to 12 months, they will come into the office and we will speak face to face.

So it really depends on the patient, the patient preference, as well as if there's anything I see that's a red flag. Maybe the camera quality is not so good. Maybe if I notice maybe they're having a little bit of movement in their jaw or their cheek, but it's not 100% clear to me and there's some red flags, I might then say, "Hey, for your next office visit, why don't you come on site. I think we'll be able to do a little bit better inspection and we can talk about our findings at that visit."

Desiree Matthews, PMHNP-BC, is a board-certified Psychiatric Mental Health Nurse Practitioner. She received her Bachelor's of Nursing from University at Buffalo and her Master's of Nursing at Stony Brook University. She currently resides in Charlotte, NC, and practices at Monarch, a community mental health center providing telepsychiatry services to adult patients. Clinical interests include the treatment of schizophrenia, bipolar disorder, treatment-resistant unipolar depression, and drug-induced movement disorders, including tardive dyskinesia. She has provided faculty expertise and insight into the development of a clinical screener for TD called MIND-TD.