Objective: To elicit and compare the treatment goals of patients with tardive dyskinesia (TD), their care partners, and healthcare providers (HCP).

Background: Tardive dyskinesia (TD) is a repetitive, involuntary movement disorder caused by prolonged exposure to a medication that inhibits the dopamine receptor. Understanding what matters to patients is critical in medical decision making with TD. Treatment decisions can influence multiple aspects of a patient’s life beyond clinical symptoms which may include emotional state, social interactions, or professional life. Nominal group technique (NGT) interviews can identify, prioritize, and compare treatment goals of both patients, their care partners, and healthcare providers to allow for improved communication and treatment satisfaction within each group.

Method: NGT was utilized to elicit and compare the treatment goals of 3 groups: patients with TD, TD care partners, and healthcare providers. Each group was asked to identify their goals for TD treatment which generated a treatment goal list for the entire group. Participants were then asked to silently identify and rank their 10 most important goals from their consolidated group list (1-most important treatment goal to 10-least important treatment goal).

Results: 5 neurologists, 5 neurology PAs, and 3 psychiatry NPs, 7 TD patients, and 5 TD care partners were interviewed using nominal group technique. HCPs generated 82 treatment goals for their TD patients, TD patients generated 43 and TD care partners, 19 treatment goals. Each participant then ranked their top 10 treatment goals from the group-generated list. The data was sorted to determine the overall top 10 treatment goals for each group. Healthcare providers top treatment goal for their TD patients was “improve quality of life as able”, TD patients top goal was “for this to go away”, and TD care partners was “reduce symptoms without adding new side effects”.

Conclusion: Differences between treatment goals generated by TD patients and HCPs were identified. Goals generated by patients typically involved improvement of day-to-day symptoms and functioning, whereas, HCPs goals were focused towards medication and disease management. Understanding these differences may lead to improved communication between TD patients and their healthcare providers which in turn may enhance treatment satisfaction.

References: References: 1. Atlas, S.J., Agboola, F., Otuonye, I., Kumar, V., Segel, C., Chapman, R., Ollendorf, D.A., & Pearson, S.D. (2017) Vesicular Monoamine Transporter 2 Inhibitors for Tardive Dyskinesia: Effectiveness and Value. Institute for Clinical and Economic Review, October, 2, 2017. 2. Col, N.F., Solomon, A.J., Springmann, V., Garbin, C.P., Ionete, C., Pbert, L., Alvarez, E., Tierman, B., Hopson, A., Kutz, C., Berrios Morales, I., Griffin, C., Phillips, G., & Ngo, L.H. Whose Preferences Matter? A Patient-Centered Approach for Eliciting Treatment Goals. Medical Decision Making, 38(1), 44-55.doi:10.1177/02722989×17724434. 3. Niemann, N., & Jankovic, J. (2018). Treatment of Tardive Dyskinesia: A General Overview with Focus on the Vesicular Monoamine Transporter 2 Inhibitors. Drugs. Doi:10.1007/s40265-018-0874-x.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/patient-centered-approach-to-elicit-and-compare-the-treatment-goals-of-patients-with-tardive-dyskinesia-their-care-partners-and-healthcare-providers/