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Abstract Details

Treatment Perceptions and Decision-Making Among Physicians Treating Essential Tremor
Movement Disorders
P5 - Poster Session 5 (11:45 AM-12:45 PM)
5-008
ET is among the most prevalent movement disorders in adults. However, ET treatment goals and medication prescribing patterns in the US are not well characterized.

To characterize the Essential Tremor (ET) patient population, explore how US physicians perceive goals and efficacy of ET pharmacotherapy, and determine medications prescribed by neurologists versus primary care physicians (PCPs).

Forty PCPs and 61 neurologists, including 24 movement disorder specialists (MDS), completed a questionnaire with 7-point Likert items (1=not important/low association, 7=extremely important/strong association) exploring treatment goals and perceived efficacy of medications used in patients with ET under their management.

Surveyed physicians reported seeing ≈3,000 patients with ET each month in total. 51% were ≥65 years of age; only 3% were ≤18 years of age. Overall, 57% of patients were reported to have moderate/severe ET (neurologists: 61% vs. PCPs: 53%; P=0.17). The most prescribed medications were propranolol (34%), primidone (27%), topiramate (11%), gabapentin (11%), clonazepam (10%), and atenolol (10%). Compared to neurologists, PCPs prescribed primidone to a lower proportion of patients and atenolol to a higher proportion (P<0.05). Across physicians, treatment goals rated as most important were maintaining quality of life, maintaining function, reducing hand tremor, tolerability, long-term efficacy, patient compliance, and slowing disease progression (mean importance ≥6.0). The importance of long-term efficacy and patient compliance were rated higher by neurologists than PCPs (P<0.01). Both neurologists and PCPs rated medications as having limited-to-moderate effect (mean range: 1.8-4.9) on top-rated attributes, with variation by physician type and medication.

Most surveyed physicians prioritized patient function and well-being in the treatment of adults with ET. Although PCPs and neurologists differ partly in treatment patterns, goals, and perception of drug efficacies, the overall consensus is that current medications are inadequate in addressing patient-relevant outcomes, highlighting an unmet need for more effective pharmacotherapy.

Authors/Disclosures
Margaret Gerbasi, PhD (Sage Therapeutics, Inc.)
PRESENTER
Ms. Gerbasi has received personal compensation for serving as an employee of Sage Therapeutics, Inc.. Ms. Gerbasi has stock in Sage Therapeutics. Ms. Gerbasi has received intellectual property interests from a discovery or technology relating to health care.
Rodger J. Elble, MD, PhD, FAAN (Southern IL Univ Sch of Med) Dr. Elble has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz. Dr. Elble has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sage . Dr. Elble has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ES Therapeutics. Dr. Elble has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Applied Therapeutics. Dr. Elble has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Praxis.
Eddie Jones, BA Eddie Jones, BA has nothing to disclose.
Alexander James Gillespie (Adelphi Real World) Mr. Gillespie has nothing to disclose.
John Jarvis, Other (Medicus Economics, LLC) Mr. Jarvis has nothing to disclose.
Elizabeth Chertavian, Other (Medicus Economics, LLC) Mrs. Chertavian has nothing to disclose.
Zachary James Smith, PhD (Medicus Economics) Dr. Smith has nothing to disclose.
Kemi Bankole, MBBS (Sage Therapeutics) Dr. Bankole has received personal compensation for serving as an employee of Sage Therapeutics. Dr. Bankole has stock in Sage Therapeutics.
Sriram Shankar, PhD (Biogen) Dr. Shankar has received personal compensation for serving as an employee of Biogen. Dr. Shankar has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Trinity Lifesciences, Triangle Insights Group. Dr. Shankar has stock in Biogen. Dr. Shankar has stock in Multiple Biotech Companies.
Ludy Chen Shih, MD, FAAN (Boston University) Dr. Shih has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Encora Therapeutics. Dr. Shih has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Supernus. Dr. Shih has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for WCG Medavante. Dr. Shih has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Shih has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley . The institution of Dr. Shih has received research support from Abbott. The institution of Dr. Shih has received research support from Praxis Precision Medicines. The institution of Dr. Shih has received research support from Tremor Research Group. Dr. Shih has received personal compensation in the range of $500-$4,999 for serving as a Consultant with German Accelerator. Dr. Shih has received personal compensation in the range of $500-$4,999 for serving as a Grant Reviewer with National Institutes of Health. Dr. Shih has received personal compensation in the range of $500-$4,999 for serving as a Grant Reviewer with Michael J. Fox Foundation. Dr. Shih has received personal compensation in the range of $500-$4,999 for serving as a Grant Reviewer with Johns Hopkins.