Date of Award

Spring 5-2022

Degree Type

Dissertation/Thesis

Degree Name

Doctor of Nursing Practice (DNP)

School

Leadership and Advanced Nursing Practice

Committee Chair

Dr. Carolyn Coleman

Committee Chair School

Leadership and Advanced Nursing Practice

Committee Member 2

Dr. Marti Jordan

Committee Member 2 School

Leadership and Advanced Nursing Practice

Abstract

Prior to the FDA approval of VMAT2 inhibitors for the treatment of tardive dyskinesia (TD), few concrete treatment options were available for TD. The most common management strategy would include switching a patient from an FGA to an SGA while discontinuing any anticholinergic medications the patient was currently taking. Other options included changing, decreasing, or discontinuing the antipsychotic. Augmenting stable antipsychotic regimens, however, may not be feasible in the management of schizophrenia as antipsychotics are foundational in the treatment of schizophrenia. A retrospective chart review was performed on 70 records that were chosen through a convenience sample of patients being treated by one physician and two nurse practitioners. The main intervention was the initiation of a VMAT2 inhibitor for the treatment of TD, therefore no records were identified for comparison with the intervention of initiation of a VMAT2 inhibitor. AIMs scores at four, eight, and twelve weeks after VMAT2 initiation were identified. Fifteen (N=15) records were identified to meet inclusion criteria for the DNP project. All records included patients between the ages of 25 to 65 on an approved VMAT2 inhibitor for at least 90 days, with a diagnosis within the DSM-V Schizophrenia Spectrum and other Psychotic Disorders of either schizophrenia, schizophreniform disorder, schizotypal disorder, delusional disorder, or schizoaffective disorder. The data from this DNP project shows that VMAT2 inhibitors are very effective in reducing tardive dyskinesia symptoms based on the AIMS scale scores and a statistically significant mean 4.27% decrease in AIMS scale scores overall in the 12-week period, which is comparable to results obtained by previous studies.

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