Abstract Details

Title TeleSCOPE: A Real-World Study of Telehealth for the Detection and Treatment of Drug-Induced Movement Disorders

Topic Movement Disorders

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-002

Objective

This observational study, “Real-World Tele-Health Evaluation of Tardive Dyskinesia (TD) Symptoms Communication/Observation Procedure Evaluation in Outpatient Clinical Settings” (TeleSCOPE), was conducted to examine how telehealth affects the assessment and management of drug-induced movement disorders (DIMDs).

Background

All patients taking an antipsychotic or other dopamine receptor blocking agent should be screened regularly for TD and other DIMDs. However, the rapid shift from in-person to telehealth visits during the COVID-19 pandemic may have made it more difficult to evaluate patients with DIMDs.

Design/Methods 20-minute online surveys were conducted with neurology and psychiatry specialists who met the following criteria: ≥3 years of practice with ≥70% of time spent in clinic; prescribed a vesicular monoamine transporter 2 (VMAT2) inhibitor or benztropine for DIMD in the past 6 months; and conducted telehealth visits with ≥15% of patients from Dec-2020 to Jan-2021.

Results Respondents included 277 clinicians (neurology=109, psychiatry=168). Telehealth visits increased after COVID-19, with greater increases in psychiatry versus neurology: phone (38% vs 21%); video (49% vs 42%). Across both specialties, the top drivers/prompts for further evaluation of DIMDs were mention of tics/movements by family/others (86%), trouble with gait/falls/walking/standing (82%), and difficulty swallowing/eating (74%). However, virtual management was challenging, and many at-risk patients (i.e., taking a dopamine receptor blocking agent) were not evaluated for DIMDs in phone-only visits (psychiatry=76%, neurology=91%). Patients without a caregiver, along with lower functioning patients, were at the highest risk of a missed DIMD diagnosis.

Conclusions During the COVID-19 pandemic, telehealth significantly reduced clinicians' ability or willingness to evaluate, diagnose, and monitor DIMDs, with multiple factors contributing to missed/incorrect diagnoses. In-person evaluation continues to be the gold standard for managing DIMDs. If telehealth is necessary, specific questions and directions are recommended.

Authors/Disclosures
Morgan Bron PRESENTER	Morgan Bron has received personal compensation for serving as an employee of Neurocrine Biosciences, Inc.. Morgan Bron has stock in Neurocrine.
Rimal Bera (University of California, Irvine School of Medicine)	Dr. Bera has nothing to disclose.
	No disclosure on file
Kendra Martello (Neurocrine Biosciences)	No disclosure on file
	No disclosure on file

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