Telehealth a Barrier to Management of Drug-Induced Movement Disorders

Investigators participating in the TeleSCOPE study deployed a survey to evaluate the management of drug-induced movement disorders via telehealth during the COVID-19 pandemic.

The following article is a part of conference coverage from Psych Congress 2021 , held October 29th through November 1, 2021, in San Antonio, Texas. The team at Psychiatry Advisor will be reporting on the latest news and research conducted by leading experts in psychiatry. Check back for more from the Psych Congress 2021.


Telehealth was found to impair the ability of clinicians to manage drug-induced movement disorders (DIMDs) in patients being treated with either a vesicular monoamine transporter 2 (VMAT2) inhibitor or benztropine, according to study results recently presented at Psych Congress 2021, held from October 29 to November 1, 2021, in San Antonio, Texas.

This observational study, the Real-World Tele-Health Evaluation of Tardive Dyskinesia (TD) Symptoms Communication/Observation Procedure Evaluation in Outpatient Clinical Settings (TeleSCOPE), included 277 clinician respondents (psychiatry, n=168; neurology, n=109). Study participants had at least 3 years of practice, at least 70% of which was spent seeing patients; had prescribed benztropine and/or VMAT2 for a DIMD within the past 6 months; and employed telehealth to conduct visits with at least 15% of patients within the period from December 2020 to January 2021. All participants completed a 20-minute online survey.

Although telehealth visits increased for both specialties during the COVID-19 pandemic, psychiatry experienced a greater increase than neurology for both phone (38% vs 21%) and video (49% vs 42%) visits. Further DIMD assessment was most commonly prompted by mentions of movements or tics by others (89% neurology vs 149% psychiatry), trouble walking/standing or with gait/falls (84% vs 143%), and reported difficulty eating or swallowing (75% vs 131%). However, managing these problems via telehealth proved challenging, and many individuals determined to be at risk (for example, those taking dopamine receptor­-blocking agents) did not undergo DIMD evaluation in visits conducted by phone only (91% vs 76%). The highest risk for a missed DIMD diagnosis was among patients without a caregiver and those with lower function.

The study authors concluded, “During the COVID-19 pandemic, telehealth significantly reduced clinicians’ ability or willingness to diagnose, assess, and monitor/treat DIMDs,” with multiple factors contributing to this situation.  “In-person evaluation continues to be the gold standard for assessing and treating DIMDs.” The study authors also noted that “the use of pre-visit materials … and specific questions and directions during virtual visits may improvement communication and lead to more accurate assessments.”

Disclosure: This clinical trial was supported by Neurocrine Biosciences, Inc. Please see the original reference for a full list of authors’ disclosures.


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Bera R, Franey E, Martello K, Bron M, Yonan C. TeleSCOPE: a real-world study of telehealth for the detection and treatment of drug-induced movement disorders. Presented at: Psych Congress 2021; October 29-November 1, 2021; San Antonio, Texas.  Poster 122.