Tanner Caroline M, Caroff Stanley N, Cutler Andrew J, Lenderking William R, Shalhoub Huda, Pagé Véronique, Franey Ericha G, Serbin Michael, Yonan Chuck
Weill Institute for Neurosciences, Department of Neurology, University of California - San Francisco, 1651 4th Street, San Francisco, CA, 94158, USA.
Parkinson's Disease Research, Education and Clinical Center, San Francisco Veterans Affairs Health Care System, 4150 Clement St., San Francisco, CA, 94121, USA.
J Patient Rep Outcomes. 2023 Mar 9;7(1):21. doi: 10.1186/s41687-023-00551-5.
Tardive dyskinesia (TD) is a persistent and potentially disabling movement disorder associated with antipsychotic use. Data from RE-KINECT, a real-world study of antipsychotic-treated outpatients, were analyzed to assess the effects of possible TD on patient health and social functioning.
Analyses were conducted in Cohort 1 (patients with no abnormal involuntary movements) and Cohort 2 (patients with possible TD per clinician judgment). Assessments included: EuroQoL's EQ-5D-5L utility (health); Sheehan Disability Scale (SDS) total score (social functioning); patient- and clinician-rated severity of possible TD ("none", "some", "a lot"); and patient-rated impact of possible TD ("none", "some", "a lot"). Regression models were used to analyze the following: associations between higher (worse) severity/impact scores and lower (worse) EQ-5D-5L utility (indicated by negative regression coefficients); and associations between higher (worse) severity/impact scores and higher (worse) SDS total score (indicated by positive regression coefficients).
In Cohort 2 patients who were aware of their abnormal movements, patient-rated TD impact was highly and significantly associated with EQ-5D-5L utility (regression coefficient: - 0.023, P < 0.001) and SDS total score (1.027, P < 0.001). Patient-rated severity was also significantly associated with EQ-5D-5L utility (- 0.028, P < 0.05). Clinician-rated severity was moderately associated with both EQ-5D-5L and SDS, but these associations were not statistically significant.
Patients were consistent in evaluating the impacts of possible TD on their lives, whether based on subjective ratings ("none", "some", "a lot") or standardized instruments (EQ-5D-5L, SDS). Clinician-rated severity of TD may not always correlate with patient perceptions of the significance of TD.
迟发性运动障碍（TD）是一种与使用抗精神病药物相关的持续性且可能致残的运动障碍。对RE-KINECT（一项针对接受抗精神病药物治疗的门诊患者的真实世界研究）的数据进行分析，以评估可能的TD对患者健康和社会功能的影响。
在队列1（无异常不自主运动的患者）和队列2（根据临床医生判断可能患有TD的患者）中进行分析。评估包括：欧洲生活质量量表的EQ-5D-5L效用值（健康状况）；希恩残疾量表（SDS）总分（社会功能）；患者和临床医生评定的可能TD的严重程度（“无”“有一些”“很多”）；以及患者评定的可能TD的影响（“无”“有一些”“很多”）。使用回归模型分析以下内容：较高（较差）严重程度/影响得分与较低（较差）EQ-5D-5L效用值之间的关联（以负回归系数表示）；以及较高（较差）严重程度/影响得分与较高（较差）SDS总分之间的关联（以正回归系数表示）。
在知晓自身异常运动的队列2患者中，患者评定的TD影响与EQ-5D-5L效用值（回归系数：-0.023，P<0.001）和SDS总分（1.027，P<0.001）高度显著相关。患者评定的严重程度也与EQ-5D-5L效用值显著相关（-0.028，P<0.05）。临床医生评定的严重程度与EQ-5D-5L和SDS均呈中度相关，但这些关联无统计学意义。
无论基于主观评定（“无”“有一些”“很多”）还是标准化工具（EQ-5D-5L、SDS），患者在评估可能的TD对其生活的影响方面是一致的。临床医生评定的TD严重程度可能并不总是与患者对TD重要性的认知相关。
