Health worse in patients concerned about developing drug-induced movement disorders

Patients from community mental health centers who expressed concerns about developing drug-induced movement disorders tended to report worse health and daily functioning, according to study results presented at NEI Congress.

They also had more negative thoughts and beliefs related to their psychiatric medications, as well as more medication side effects.

“Drug-induced movement disorders (DIMDs), such as tardive dyskinesia, tics, parkinsonism, akathisia and dystonia may occur in patients treated with antipsychotics,” Allison Stiles, MA, of the CommonGround Program in Massachusetts, said during a virtual presentation. “The online CommonGround Program works with community mental health centers to support the recovery and healing of psychiatric outpatients through tools which facilitate better patient-doctor communication.”

Stiles and colleagues analyzed patient-reported data included in CommonGround between August 2007 and April 2020 to examine possible effects of DIMD concerns on functioning and beliefs related to psychiatric prescriptions. They based methods on patients’ responses to an online questionnaire completed in the waiting room prior to their regular office visit and limited the analysis to patients who treated with an antipsychotic. For outcomes, they assessed health and functioning, based on “How I am Doing” questions and rated according to a five-point scale, as well as medication concerns and beliefs, based on “Medication Concerns” questions and rated as “yes” or “no.”

Further, the researchers stratified outcomes by patients’ concerns related to movement disorders, which they based on a question that assessed concerns regarding developing DIMDs. They defined subgroups as patients concerned about movement disorder (MD-YES) or those not concerned (MD-NO). They analyzed all data descriptively according to each patient’s first office visit in the database.

Results showed 312 (4%) and 7,562 (96%) of 7,874 patients in the MD-YES and MD-NO subgroups, respectively. Those in the MD-YES subgroup had a higher rate of poor health and functional outcomes, with negative thoughts and beliefs related to psychiatric medications common among this group. This group often reported medication side effects.

“The causal effects of patients’ concerns about DIMDs and on daily functioning or medication beliefs cannot be deduced based on these analyses,” Stiles said. “Recognizing patients’ concerns about DIMDs may help clinicians when discussing treatment options, should they occur, which could increase patient confidence, encourage adherence to treatment and potentially improve outcomes.”