Real-World Claims Analysis to Characterize the Burden of Tardive Dyskinesia in Long-Term Care Settings

Abstract: Tardive dyskinesia (TD) is a persistent and potentially debilitating movement disorder associated with antipsychotic exposure. Older adults have an increased risk for TD and may be particularly vulnerable to its impacts (e.g., impaired balance, difficulty swallowing), potentially complicating clinical management in long-term care (LTC) settings. To better understand the impact of TD in LTC settings, analyses were conducted using the STATinMED Real-World Data Insights Database, which captures 80% of US claims data. Comorbidities, medication use, and healthcare visits were analyzed in 2,294 patients who met the following stringent criteria: ≥1 LTC stay from Jan 2017 to Dec 2021, with “index stay” defined as the first LTC stay; ICD-10 code of G24.01 (indicative of TD) on or before the index stay; and claims benefits for ≥1 year before and after the index stay. In these patients with TD and ≥1 LTC stay, 64.6% were ≥65 years and 67.3% were female. The mean (±SD) Charlson Comorbidity Index (CCI) score was 3.72 (±4.2), and 32.8% had a CCI score ≥4, indicating high comorbidity burden and increased mortality risk. The most common comorbidities were mood disorders (66.1%) and schizophrenia (38.8%), corresponding to the common use of antidepressants (56.1%) and antipsychotics (50.4%). Polypharmacy was common, with 47.9% of patients having prescriptions for ≥3 central nervous system medications, including anticholinergics (50.0%). Within 1-year post-index, 47.3% had ≥1 emergency department visit. The comorbidity, polypharmacy, and healthcare resource utilization in this real-world patient population points to the importance of effective TD treatment in LTC settings.Short Description: In this real-world study of patients with tardive dyskinesia (TD) in long-term care (LTC) settings, 64.6% were elderly, comorbidity burden was high, and emergency department visits were common. Polypharmacy with drugs such as antipsychotics (which can cause TD) and anticholinergics (which can worsen TD) was also common. These data highlight the need for medications that are effective in elderly patients and can be easily administered to those with dysphagia, an important consideration in LTC settings.Name of Sponsoring Organization(s): Neurocrine Biosciences, Inc.