Nurse practitioner educational preparation and confidence related to managing antipsychotic medications and associated drug-induced movement disorders

Abstract

Background:Antipsychotic medications (APMs) have been used to treat multiple psychiatric disorders for decades. The conditions to use these medications have expanded from primarily psychotic disorders to Food and Drug Administration–approved uses as first-line mood stabilizers in bipolar disorder and adjunctive pharmacotherapy in unipolar depression. Antipsychotic medications can have serious side effects, including drug-induced movement disorders (DIMDs). Nurse practitioners (NPs) in non–psychiatric-mental health specialties are increasingly managing psychotropic medication regimes. There is a void in peer-reviewed literature capturing the scope of NPs managing APMs, such as whether they received training to prescribe and manage risks of APM, and if so, what type (e.g., continuing education, attending conferences, consulting), and their confidence assessing and managing DIMDs.Purpose:To describe the scope of NP management, knowledge, and confidence related to APMs and associated risks of DIMDs.Methodology:Nonexperimental, descriptive, cross-sectional survey. Participants (n = 400) recruited through a professional association membership portal.Results:Nearly two-thirds of participants reported managing APMs (64%) and receiving training to prescribe and manage risks of APMs (63%). More than half (54%) reported they received training to do so in their NP education program. Thirty-five percent of participants indicated they were either completely (6%) or fairly (29%) confident, whereas most (65%) endorsed being somewhat (26%), slightly (20%), or not (19%) confident in assessing and managing DIMDs.Conclusions/Implications:Opportunities exist to broaden NP education in managing APMs and associated risks of DIMDs.

Understanding Drug-Induced Movement Disorders: Causes, Symptoms, and Treatment

“…It is important to note that pharmacological treatments for DIMDs should be carefully considered and monitored by a healthcare professional [128]. The choice of medication, dose, and duration of therapy should be tailored to the individual's specific needs and circumstances.…”

Overview of Movement Disorders Secondary to Drugs

“…DIP was recognized in the early 1950s with antipsychotic drugs. It was reported that DIP occurs during the initial period of antipsychotic medication exposure [ 55 ]. The pathophysiology of DIP is related to disruptions in the basal ganglia motor pathways secondary to dopaminergic receptor blockade [ 56 ].…”