Abstract Details

Title Functional Movement Disorder Program Outcomes: Insights from an Eight-year Quality Improvement Initiative

Topic Movement Disorders

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 16-015

Objective To describe the demographic, clinical, and outcome characteristics of patients evaluated for Functional Movement Disorder (FMD) in a large multidisciplinary program over an eight-year period as part of a quality improvement initiative.

Background Functional movement disorder (FMD) is a common yet underrecognized cause of disability. A multidisciplinary clinic was established to provide coordinated, patient-centered care integrating neurology, psychology, and rehabilitation to promote functional recovery.

Design/Methods A retrospective review included all patients evaluated between 2016 and 2024 in the multidisciplinary FMD clinic. Demographics, medication use, and patient-reported outcomes were extracted from standardized electronic records and summarized descriptively. The project was reviewed and deemed a quality improvement activity; IRB approval was not required per institutional policy.

Results A total of 3,260 patients were evaluated (mean age 52.4 ± 17.2 years; 67% female; median education = 14 years [IQR 12–16]). Common comorbidities included psychiatric diagnoses (32%), pain disorders (28%), and neurological conditions such as migraine, tremor, or epilepsy (25%). PROMIS scores reflected below-average physical and mental health (37.6 ± 8.8; 39.5 ± 9.8) and moderate pain interference (4.7 ± 2.6). Mean GAD-7 and PHQ-9 scores were 8.0 ± 6.3 and 9.4 ± 6.6, respectively. Among 1,960 patients with available medication data, 85% used ≥1 medication, most commonly antiseizure drugs (36%), SSRIs (23%), SNRIs (21%), and benzodiazepines (19%). The mean simplified FMD Rating Scale score (n = 211) was 9.8 ± 8.4. Overall, 27% (n = 884) participated in virtual shared medical appointments, and 17% (n = 565) completed neuropsychological evaluation.

Conclusions This eight-year initiative demonstrates the sustainability and scalability of a multidisciplinary model for FMD care. Integration of behavioral health and rehabilitation within neurology was associated with improved diagnostic consistency, treatment engagement, and continuity of care. Routine collection of patient-reported outcomes provides a framework for individualized treatment planning and ongoing program evaluation.

Authors/Disclosures
Tatiana Lopez, MD PRESENTER	Dr. Lopez has nothing to disclose.
Megan Zelinsky, MA	Prof. Zelinsky has nothing to disclose.
Erin M. Kilbane, RN	Mrs. Kilbane has nothing to disclose.
Afiah Hasnie, PsyD	Dr. Hasnie has nothing to disclose.
Cynthia Van Keuren, PsyD	Dr. Van Keuren has nothing to disclose.
Taylor Rush, PhD	Dr. Rush has nothing to disclose.
Umar A. Shuaib, MBBS (Cleveland Clinic)	Dr. Shuaib has nothing to disclose.
Xin Xin Yu, MD (Cleveland Clinic)	No disclosure on file

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