{"title":"长期护理环境中迟发性运动障碍负担特征的真实世界索赔分析。","authors":"Morgan Bron, Gideon Aweh, Eric Jen, Amita Patel","doi":"10.1007/s40120-025-00820-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Tardive dyskinesia (TD), a persistent and often debilitating movement disorder, is associated with prolonged exposure to dopamine receptor-blocking agents. Individuals aged ≥ 60 years are at increased risk for TD and TD-related burden (e.g., impaired balance, difficulty swallowing), which can complicate management in long-term care (LTC) settings. We evaluated the prevalence of TD diagnoses and characterized the populations, treatment patterns, and healthcare resource utilization within specific LTC settings.</p><p><strong>Methods: </strong>This retrospective, longitudinal, observational study used the STATinMED Real-World Insights Database (1/2017-12/2012). Commercial, Medicaid, and Medicare enrollees with a TD diagnosis code who had ≥ 1 LTC stay, continuous claims data capture for ≥ 1 year pre-LTC facility admission, and ≥ 1 year post-LTC facility discharge were included. Demographics and clinical characteristics were captured for 12 months pre-LTC index stay. Clinical outcomes were collected for 12 months post-index LTC stay.</p><p><strong>Results: </strong>Of 20,176 patients identified, 2294 had ≥ 2 years continuous benefits and were included. Most patients were aged ≥ 65 years (64.6%), female (67.3%), and Medicare enrollees (76.8%). Mean Charlson Comorbidity Index score was 3.72 (standard deviation: 4.2) for all patients, suggesting high comorbidity burden. Two-thirds (66.1%) of the population had mood disorders, and antidepressants were the most widely used medication (56.1%). Polypharmacy was prevalent: nearly half (47.9%) of the population was prescribed ≥ 3 medications with central nervous system properties, which can increase risk of falls and cognitive impairment in older adults; 64.8% of patients had ≥ 1 emergency department visit any time post-LTC stay.</p><p><strong>Conclusions: </strong>Our findings demonstrated individuals with TD in LTC settings have a high comorbidity burden and polypharmacy, particularly for medications with anticholinergic properties. Further investigation is warranted to evaluate the impact of TD in older adults in LTC settings and explore interventional practices that can improve clinical outcomes, such as falls with injury and activities of daily living decline.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"2217-2226"},"PeriodicalIF":4.8000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450166/pdf/","citationCount":"0","resultStr":"{\"title\":\"Real-World Claims Analysis to Characterize the Burden of Tardive Dyskinesia in Long-Term Care Settings.\",\"authors\":\"Morgan Bron, Gideon Aweh, Eric Jen, Amita Patel\",\"doi\":\"10.1007/s40120-025-00820-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Tardive dyskinesia (TD), a persistent and often debilitating movement disorder, is associated with prolonged exposure to dopamine receptor-blocking agents. Individuals aged ≥ 60 years are at increased risk for TD and TD-related burden (e.g., impaired balance, difficulty swallowing), which can complicate management in long-term care (LTC) settings. We evaluated the prevalence of TD diagnoses and characterized the populations, treatment patterns, and healthcare resource utilization within specific LTC settings.</p><p><strong>Methods: </strong>This retrospective, longitudinal, observational study used the STATinMED Real-World Insights Database (1/2017-12/2012). Commercial, Medicaid, and Medicare enrollees with a TD diagnosis code who had ≥ 1 LTC stay, continuous claims data capture for ≥ 1 year pre-LTC facility admission, and ≥ 1 year post-LTC facility discharge were included. Demographics and clinical characteristics were captured for 12 months pre-LTC index stay. Clinical outcomes were collected for 12 months post-index LTC stay.</p><p><strong>Results: </strong>Of 20,176 patients identified, 2294 had ≥ 2 years continuous benefits and were included. Most patients were aged ≥ 65 years (64.6%), female (67.3%), and Medicare enrollees (76.8%). Mean Charlson Comorbidity Index score was 3.72 (standard deviation: 4.2) for all patients, suggesting high comorbidity burden. Two-thirds (66.1%) of the population had mood disorders, and antidepressants were the most widely used medication (56.1%). Polypharmacy was prevalent: nearly half (47.9%) of the population was prescribed ≥ 3 medications with central nervous system properties, which can increase risk of falls and cognitive impairment in older adults; 64.8% of patients had ≥ 1 emergency department visit any time post-LTC stay.</p><p><strong>Conclusions: </strong>Our findings demonstrated individuals with TD in LTC settings have a high comorbidity burden and polypharmacy, particularly for medications with anticholinergic properties. Further investigation is warranted to evaluate the impact of TD in older adults in LTC settings and explore interventional practices that can improve clinical outcomes, such as falls with injury and activities of daily living decline.</p>\",\"PeriodicalId\":19216,\"journal\":{\"name\":\"Neurology and Therapy\",\"volume\":\" \",\"pages\":\"2217-2226\"},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450166/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurology and Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s40120-025-00820-z\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/9/4 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurology and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40120-025-00820-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/4 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Real-World Claims Analysis to Characterize the Burden of Tardive Dyskinesia in Long-Term Care Settings.
Introduction: Tardive dyskinesia (TD), a persistent and often debilitating movement disorder, is associated with prolonged exposure to dopamine receptor-blocking agents. Individuals aged ≥ 60 years are at increased risk for TD and TD-related burden (e.g., impaired balance, difficulty swallowing), which can complicate management in long-term care (LTC) settings. We evaluated the prevalence of TD diagnoses and characterized the populations, treatment patterns, and healthcare resource utilization within specific LTC settings.
Methods: This retrospective, longitudinal, observational study used the STATinMED Real-World Insights Database (1/2017-12/2012). Commercial, Medicaid, and Medicare enrollees with a TD diagnosis code who had ≥ 1 LTC stay, continuous claims data capture for ≥ 1 year pre-LTC facility admission, and ≥ 1 year post-LTC facility discharge were included. Demographics and clinical characteristics were captured for 12 months pre-LTC index stay. Clinical outcomes were collected for 12 months post-index LTC stay.
Results: Of 20,176 patients identified, 2294 had ≥ 2 years continuous benefits and were included. Most patients were aged ≥ 65 years (64.6%), female (67.3%), and Medicare enrollees (76.8%). Mean Charlson Comorbidity Index score was 3.72 (standard deviation: 4.2) for all patients, suggesting high comorbidity burden. Two-thirds (66.1%) of the population had mood disorders, and antidepressants were the most widely used medication (56.1%). Polypharmacy was prevalent: nearly half (47.9%) of the population was prescribed ≥ 3 medications with central nervous system properties, which can increase risk of falls and cognitive impairment in older adults; 64.8% of patients had ≥ 1 emergency department visit any time post-LTC stay.
Conclusions: Our findings demonstrated individuals with TD in LTC settings have a high comorbidity burden and polypharmacy, particularly for medications with anticholinergic properties. Further investigation is warranted to evaluate the impact of TD in older adults in LTC settings and explore interventional practices that can improve clinical outcomes, such as falls with injury and activities of daily living decline.
期刊介绍：
Aims and Scope
Neurology and Therapy aims to provide reliable and inclusive, rapid publication for all therapy related research for neurological indications, supporting the timely dissemination of research with a global reach, to help advance scientific discovery and support clinical practice.
Neurology and Therapy is an international, open access, peer reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world and health outcomes research around the discovery, development, and use of neurological and psychiatric therapies, (also covering surgery and devices). Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also welcomed.
The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, case reports, trial designs, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Neurology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
Rapid Publication
The journal’s rapid publication timelines aim for a peer review decision within 2 weeks of submission. If an article is accepted, it will be published online 3-4 weeks from acceptance. These rapid timelines are achieved through the combination of a dedicated in-house editorial team, who closely manage article workflow, and an extensive Editorial and Advisory Board who assist with rapid peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model, this allows for the rapid and efficient communication of the latest research and reviews to support scientific discovery and clinical practice.
Open Access
All articles published by Neurology and Therapy are open access.
Personal Service
The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning that authors will always have a personal point of contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. We also encourage pre-submission enquiries and are always happy to provide a confidential assessment of manuscripts.
Digital Features and Plain Language Summaries
Neurology and Therapy offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by key summary points, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article. The journal also provides the option to include various types of digital features including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations. All additional features are peer reviewed to the same high standard as the article itself. If you consider that your paper would benefit from the inclusion of a digital feature, please let us know. Our editorial team are able to create high-quality slide decks and infographics in-house, and video abstracts through our partner Research Square, and would be happy to assist in any way we can. For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’.
For examples of digital features please visit our showcase page https://springerhealthcare.com/expertise/publishing-digital-features/
Publication Fees
Upon acceptance of an article, authors will be required to pay the mandatory Rapid Service Fee of €5250/$6000/£4300. The journal will consider fee discounts and waivers for developing countries and this is decided on a case-by-case basis.
Peer Review Process
Upon submission, manuscripts are assessed by the editorial team to ensure they fit within the aims and scope of the journal and are also checked for plagiarism. All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria.
At least two extensive reviews are required to make the editorial decision, with the exception of some article types such as Commentaries, Editorials and Letters which are generally reviewed by one member of the Editorial Board. Where reviews conflict, an Editorial Board Member will be contacted for further advice and a presiding decision. Manuscripts are then either accepted, rejected or authors are required to make major or minor revisions (both reviewer comments and editorial comments may need to be addressed. Once a revised manuscript is re-submitted, it is assessed along with the responses to reviewer comments and if it has been adequately revised, it will be accepted for publication. Accepted manuscripts are then copyedited and typeset by the production team before online publication. Appeals against decisions following peer review are considered on a case-by-case basis and should be sent to the journal editor, and authors are welcome to make rebuttals against individual reviewer comments, if appropriate.
Preprints
We encourage posting of preprints of primary research manuscripts on preprint servers, authors'' or institutional websites, and open communications between researchers whether on community preprint servers or preprint commenting platforms. Posting of preprints is not considered prior publication and will not jeopardize consideration in our journals.
Please see here for further information on preprint sharing: https://www.springer.com/gp/authors-editors/journal-author/journal-author-helpdesk/submission/1302#c16721550
Copyright
Neurology and Therapy is published under the Creative Commons Attribution-Noncommercial License, which allows users to read, copy, distribute, and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited. The author assigns the exclusive right to any commercial use of the article to Springer. For more information about the Creative Commons Attribution-Noncommercial License, click here: http://creativecommons.org/licenses/by-nc/4.0.
Contact
For more information about the journal, including pre-submission enquiries, please contact managing editor Lydia Alborn at lydia.alborn@springer.com.
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