(#53) Clinical and Demographic Characteristics of Patients Taking Antipsychotics and Treatment Patterns Among Patients With Tardive Dyskinesia in a Long-Term Care Setting

Abstract: Background: This study described the clinical/demographic characteristics of patients taking antipsychotics/metoclopramide in a long-term care (LTC) setting and treatment patterns for patients with tardive dyskinesia (TD). Methods: A retrospective Electronic Health Record analysis of PointClickCareís life science database was performed to identify patients aged ?18 years entering LTC who were administered antipsychotics for ?30 days or metoclopramide for ?12 weeks from January 1, 2017ñOctober 31, 2023. A second analysis (same period) investigated treatment patterns for patients with a TD ICD-10 diagnosis code and ?6 months of data before and after diagnosis. Results: Of the 700,026 patients on antipsychotics (mean age, 72 years; 55.8% female; 62.7% White), common psychiatric conditions included major depressive disorder (36.6%), bipolar disorder (17.6%), and schizophrenia (15.8%); 49.0% had dementia. Most patients (91.1%) were prescribed second-generation antipsychotics, with 23.4% prescribed first-generation antipsychotics and 14.5% prescribed both; 5.6% and 1.1% had a diagnosis of extrapyramidal syndrome and TD, respectively. Of the 2,536 patients with TD (mean age, 69 years; 60.7% female; 61.1% White), mean medication count was 14.5 at TD diagnosis. Less than half (47.4%) were treated with a vesicular monoamine transporter 2 inhibitor (VMAT2i), 53.3% with a non-VMAT2i (treatments were not mutually exclusive), and 25.1% were untreated. Most patients (>80%) were treated at TD diagnosis; for the 19.0% with a gap before initiating treatment, mean time to initiation was 295 days. Conclusions: The study highlighted inadequate treatment of TD in LTC, with less than half of patients receiving a VMAT2i and delays in treatment initiation for some.Short Description: This study described the clinical/demographic characteristics of patients taking antipsychotics/metoclopramide and examined treatment patterns among patients with tardive dyskinesia (TD) in long-term care (LTC). Patients who received an antipsychotic commonly had major depressive disorder, bipolar disorder, or schizophrenia, and nearly 50% had dementia. Less than half of patients with TD were treated with a vesicular monoamine transporter 2 inhibitor and one-quarter were untreated, suggesting inadequate treatment of TD in LTC settings.Name of Sponsoring Organization(s): Teva Branded Pharmaceutical Products R&D LLC.