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Assessing the educational needs of physicians in the management of patients with Tourette syndrome: results of a United States survey on practicing clinicians and caregivers

Published online by Cambridge University Press:  18 February 2022

Sylvie Stacy ,
Gregory D. Salinas ,
Emily Belcher ,
Amanda Wilhelm ,
Jessica K. Alexander  and
Gregory W. Mattingly Open the ORCID record for Gregory W. Mattingly [Opens in a new window]
Sylvie Stacy
Affiliation:
Department of Research and Assessment, CE Outcomes, LLC, Birmingham, AL, USA
Gregory D. Salinas
Affiliation:
Department of Research and Assessment, CE Outcomes, LLC, Birmingham, AL, USA
Emily Belcher
Affiliation:
Department of Research and Assessment, CE Outcomes, LLC, Birmingham, AL, USA
Amanda Wilhelm
Affiliation:
Movement Disorders and Psychiatry, Teva Pharmaceutical Industries, West Chester, PA, USA
Jessica K. Alexander
Affiliation:
Neurology, Teva Pharmaceutical Industries, West Chester, PA, USA
Gregory W. Mattingly*
Affiliation:
Department of Psychiatry, Washington University, St. Louis, MO, USA
*
*Author for correspondence: Gregory W. Mattingly, MD Email: greg@mattingly.com
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Abstract

Objective

To better understand current practices of U.S.-based physicians in the management of Tourette syndrome (TS) and identify gaps that may be addressed by future education.

Methods

Two survey instruments were developed to gather data on management of TS and perceptions from physicians and caregivers of children with TS. The clinician survey was developed in consultation with a TS physician expert and utilized clinical vignettes to assess and quantify practice patterns. The caregiver survey was adapted from the clinician survey and other published studies and gathered details on diagnosis, treatment, and perceptions regarding management.

Results

Data included responses from 138 neurologists (including 57 pediatric neurologists), 162 psychiatrists (including 42 pediatric psychiatrists), and 67 caregivers. Most (65%) pediatric neurologists rely solely on clinical findings to make a diagnosis, whereas the majority of other specialists utilize additional testing (eg, neuroimaging, lab testing, and genetics). Most psychiatrists (96%) utilize standardized criteria to make a diagnosis, whereas 22% of neurologists do not. Many physicians (44% of psychiatrists and 20% of neurologists) use pharmacotherapy to treat a patient with “slightly bothersome” tics and no functional impairment, whereas caregivers favored behavioral therapy. Most (76%) caregivers preferred to make the final treatment decision, whereas 80% of physicians preferred equal or physician-directed decision-making.

Conclusions

This study provides insight into practice patterns and perceptions of U.S.-based neurologists and psychiatrists in managing TS. Results highlight the potential value of physician education, including diagnostic approach, tic management and monitoring, involvement of caregivers in decision-making, and updates on TS management.

Keywords

Tourette syndromesurveyeducationmanagementtics

Information

Type
Original Research
Information
CNS Spectrums , Volume 28 , Issue 3 , June 2023 , pp. 343 - 350
Copyright
© Washington University School of Medicine, 2022

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