Impact of drug-induced Parkinsonism and tardive dyskinesia on health-related quality of life in schizophrenia

Journal of Psychopharmacology ◽

10.1177/02698811211055812 ◽

2022 ◽

pp. 026988112110558

Author(s):

Gurpreet Rekhi ◽

Jenny Tay ◽

Jimmy Lee

Keyword(s):

Quality Of Life ◽

Tardive Dyskinesia ◽

Involuntary Movement ◽

Health Related Quality ◽

Drug Induced ◽

Syndrome Scale ◽

Related Quality ◽

Health Related ◽

Negative Syndrome

Background: Both drug-induced Parkinsonism (DIP) and tardive dyskinesia (TD) have been shown to be associated with lower health-related quality of life (HRQOL) in schizophrenia, but few studies have examined their relative impact. Aims: This study aimed to examine and compare the association of DIP and TD with HRQOL in schizophrenia. Methods: In total, 903 patients with schizophrenia were assessed on the Positive and Negative Syndrome Scale (PANSS), Simpson-Angus Scale (SAS), and Abnormal Involuntary Movement Scale (AIMS). EuroQoL five-dimensional (EQ-5D-5L) utility scores were derived from PANSS scores via a previously validated algorithm and used as a measure of HRQOL. Results: In total, 160 (17.7%) participants had only DIP, 119 (13.2%) had only TD, and 123 (13.6%) had both DIP and TD. HRQOL was lowest for participants with both DIP and TD, followed by only DIP group, only TD group, and highest in the group with neither condition. HRQOL scores differed significantly between the four groups, F(3, 892) = 13.724, p < 0.001, [Formula: see text] = 0.044). HRQOL of participants having only DIP or both DIP and TD was significantly lower than those having neither condition. There was no significant interaction between the presence of DIP and TD on the association with HRQOL. Conclusions: DIP was the main antipsychotic-induced movement disorder associated with a poorer HRQOL in patients with schizophrenia. Therefore, clinicians should focus on prevention, detection, and effective management of DIP to optimize HRQOL in patients with schizophrenia.

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PND84 FACTORS THAT IMPACT HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH TARDIVE DYSKINESIA: REGRESSION ANALYSES OF DATA FROM THE REAL-WORLD RE-KINECT STUDY

Value in Health ◽

10.1016/j.jval.2019.04.1357 ◽

2019 ◽

Vol 22 ◽

pp. S285-S286

Author(s):

S.M. Caroff ◽

A.J. Cutler ◽

H. Shalhoub ◽

W.R. Lenderking ◽

K. Yeomans ◽

...

Keyword(s):

Quality Of Life ◽

Tardive Dyskinesia ◽

Real World ◽

Regression Analyses ◽

Health Related Quality ◽

The Real ◽

Related Quality ◽

Health Related

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105 Health-Related Quality of Life in Patients with Possible Tardive Dyskinesia Based on Patient and Clinician Assessments

CNS Spectrums ◽

10.1017/s1092852920000231 ◽

2020 ◽

Vol 25 (2) ◽

pp. 268-269

Author(s):

Andrew J. Cutler ◽

Stanley N. Caroff ◽

Huda Shalhoub ◽

William R. Lenderking ◽

Ericha Franey ◽

...

Keyword(s):

Quality Of Life ◽

Tardive Dyskinesia ◽

Regression Model ◽

Summary Score ◽

Health Related Quality ◽

Full Cohort ◽

Body Regions ◽

Related Quality ◽

Health Related

Abstract:Study Objective:Tardive dyskinesia (TD) is a persistent and potentially disabling movement disorder associated with prolonged antipsychotic use. RE KINECT, a real-world screening study of antipsychotic-treated outpatients, included patients with movements that were clinician-confirmed as possible TD (Cohort 2) and patients with no involuntary movements (Cohort 1). Baseline data from the patient rated EuroQoL 5-Dimension 5-Level questionnaire (EQ-5D-5L) and Sheehan Disability Scale (SDS) were analyzed to evaluate health related quality of life (Cohort 2 vs. Cohort 1) and the effects of possible TD on quality of life (Cohort 2).Methods:Assessments included EQ-5D-5L utility score (0=equivalent to death to 1=perfect health); SDS total score (0=no impact to 30=highest impact); patient- and clinician-rated severity of possible TD in 4 body regions (0=none, 1=some, and 2=a lot; summary score, 0 to 8); and patient-rated impact of possible TD in 7 daily activities (0=none, 1=some, and 2=a lot; summary score, 0 to 14). Populations included Cohort 1 (N=450); full Cohort 2 (N=204); and limited Cohort 2 (N=111, patients who self-reported “some” or “a lot” of TD severity in ≥1 body region). Mean differences between Cohort 2 and Cohort 1 in EQ-5D-5L utility and SDS total scores were analyzed using a generalized linear regression model that was adjusted for potentially confounding factors (e.g., age, sex, psychiatric diagnosis). Associations between TD summary scores (severity, impact) and quality of life (EQ-5D-5L utility, SDS total) were analyzed using a regression model.Results:The mean score difference between full Cohort 2 (N=204) and Cohort 1 (N=450) was significant for EQ-5D-5L utility (-0.037; P<0.05 [adjusted analysis]) but not SDS total (0.267; P>0.05). However, when limited to Cohort 2 patients who self-reported “a lot” of TD severity (n=53) or impact (n=33), both EQ 5D 5L utility and SDS total scores were significantly worse than in Cohort 1 (P<0.05). Regression coefficients indicated significant associations between patient-rated impact and EQ 5D-5L utility in the full Cohort 2 (-0.021, P<0.001) and limited Cohort 2 (-0.024, P<0.001). A significant association was also found with patient rated severity in limited Cohort 2 (P<0.05), but not with clinician-rated severity. Similar results were found for SDS total score.Conclusions:RE-KINECT patients were consistent in evaluating the severity and impact of TD, whether based on subjective assessments or standardized patient-reported instruments (EQ-5D-5L, SDS). Clinician-rated severity of TD may not always correlate with patient perceptions of the significance of TD. Patient self-assessments (focused on symptom impact) can be clinically relevant; incorporating such measures into everyday practice may provide a more comprehensive approach to TD assessment and management.Funding Acknowledgements:Supported by Neurocrine Biosciences, Inc.

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