(363) Real-world insights on tardive dyskinesia: a claims-based analysis of demographics and healthcare utilization

Background: : Tardive dyskinesia (TD), a persistent movement disorder associated with prolonged antipsychotic exposure, can have disabling impacts on social, physical, and emotional functioning. Older adults have a higher risk for TD, and the presence of multiple comorbidities and polypharmacy in this population can complicate clinical management in long-term care (LTC) settings.

Objective: : To examine the potential impact of TD on healthcare and resource utilization (HCRU) and LTC admissions.

Methods: : The STATinMED Real-World Data Insights Database, which captures 80% of US claims data, was used for analysis. Patients with an LTC stay and ICD-10 code indicative of TD (G24.01) during the study period (Jan 2018 to Dec 2022) were identified, with index defined as the earliest date with a claim of TD diagnosis. Demographics and comorbidities were analyzed in with patients who had continuous capture of medical and pharmacy benefits for ≥12 months before the index date (“baseline”). Medication use, HCRU, and LTC admissions were analyzed for the baseline period and for ≥12 months after the index date (“follow-up”). Mean values are presented with standard deviation (±SD).

Results: : Among 54,890 patients with TD who were included for analysis, 35,500 (65%) were female and the mean age was 60 (±14) years; 38,960 (71%) were 55 years or older. Common comorbidities included mood disorders (58%), sleep disorders (32%), schizophrenia (31%), and bipolar disorder (30%). The mean Charlson Comorbidity Index (CCI) score was 2.2 (±3.5), and 8,782 (16%) patients had a CCI score ≥5, indicating high comorbidity burden and healthcare needs. Use of antidepressants declined from baseline to follow-up (from 56% to 52%); use of drugs with anticholinergic properties (e.g., benztropine) remained stable (23% in both periods). Medical visits (outpatient office, outpatient hospital, emergency room) and inpatient care increased from baseline to follow-up. The percentage of patients with ≥1 LTC admission increased from baseline to follow-up (from 7% to 11%).

Conclusions: : The population of patients included in this real-world claims data tended to be older aged ≥55 years with high comorbidity burden. The increase in outpatient visits, inpatient visits, and LTC admissions from before to after the index date suggests a potentially greater need for healthcare services and long-term care after patients received a TD diagnosis (index date).

Sponsorship:: Neurocrine Biosciences, Inc.