A Multi-Year Survey on United States Psychiatry Clinicians: Trends on Managing Patients with Tardive Dyskinesia

Tardive dyskinesia (TD) can profoundly impact patients’ daily functioning and overall quality of life, making appropriate diagnosis and management critical. This study aimed to identify changes in practice patterns, knowledge, and barriers among United States (US) psychiatry clinicians in managing patients with TD over time and to determine how continuing medical education (CME) has impacted clinicians' adherence to guideline- and evidence-based care. A case-based survey was administered to samples of psychiatrists and psychiatry advanced practice providers (APPs) at four time points: 2018 (N&#3f213), 2020 (N&#3f125), 2021 (N&#3f100), and 2023 (N&#3f145). The 2023 survey included questions to assess recent participation in TD CME; N&#3f37 CME participants and N&#3f108 CME non-participants were identified.
The study demonstrated increased use of the Abnormal Involuntary Movement (AIM) scale for assessing TD symptoms, indicative of optimal evidence-based care. In 2018, 77% of psychiatry clinicians used a standardized movement disorder rating scale, rising to 83% by 2023. Scale use increased to 90% among the CME participant cohort. Furthermore, there was an increase in self-reported knowledge of VMAT2 inhibitors for symptom management and a significant increase in the use of VMAT2 inhibitors to manage symptoms that persisted despite antipsychotic medication dose reduction; in 2018, 44% of psychiatry clinicians recommended a VMAT2 inhibitor, which increased to 71% by 2023. Among 2023 respondents, 78% of CME participants recommended a VMAT2 inhibitor, compared to 66% of CME non-participants.
These findings highlight the evolving educational needs of psychiatry clinicians in managing TD and the positive impact of CME in closing care gaps.