The new CPNP DVD covering Drug-Induced Movement Disorders: A Clinical Guide to Rating Scales is now available for advance purchase and delivery in early March. This article reviews the inspiration for its inception and describes how this DVD will both improve your assessment skills and serve as a crucial resource for teaching other professionals in assessing medication-induced movement disorders. The featured rating scales include the Dyskinesia Identification Scale: Condensed Users Scale, Abnormal Involuntary Movement Scale, Simpson Angus Scale, and the Barnes Akathisia Rating Scale.

The initial need for quality movement disorder training tools was identified here at the Center for Behavioral Medicine in Kansas City, Missouri, when our pharmacy department was asked to facilitate the movement disorder training of the psychiatry residents and nursing staff. Historically, our PGY-2 psychiatric pharmacy residents were trained with the older VHS tapes for the Dyskinesia Identification Scale: Condensed Users Scale (DISCUS). Our facility had recently changed from utilizing the DISCUS to the Abnormal Involuntary Movement Scale (AIMS) and we could not locate a quality AIMS training tool that was available to purchase. In addition, the resident trainees were not consistently trained to perform the Simpson Angus Scale (SAS), the modified Simpson Angus Scale (MSAS) or the Barnes Akathisia Rating Scale (BARS) since no training tool existed for those scales either.

When a group of psychiatric pharmacists and psychiatrists were surveyed at the 2011 CPNP Annual Meeting regarding what movement disorder training tools they utilize and who performs the training at their facility, the vast majority were using antiquated pharma-sponsored VHS tapes and usually one psychiatric pharmacist trained all of the appropriate staff resulting in some workload issues. Additionally, facilities that lack a psychiatric pharmacist or another healthcare professional trained to administer movement disorder rating scales may not be effectively monitoring individuals with mental illness prescribed an antipsychotic placing them at increased risk for tardive dyskinesia, pseudoparkinsonism and akathisia.

This training DVD demonstrates the proper administration technique and provides scoring pearls for the AIMS, DISCUS, MSAS and BARS. A competency testing component is included for both the AIMS and the DISCUS where the viewer can observe the entire exam and compare their rating with that of the expert examiner. The examiner also explains why they choose a particular severity rating versus another. The viewer is able to see examples of mild to moderate severities in movement disorders compared to more severe examples for each scale. The expert conducting the assessment informs the viewer of the importance of administration technique and specific reasons why the exam is performed in a particular manner. The examiner also shares scoring pearls and potential pitfalls which may occur in clinical practice. The MSAS examination is shown in the video instead of the SAS since the modified version is more widely utilized in clinical practice. However, both versions are provided as printable forms at cpnp.org/dvd.

You can learn more about this DVD by listening to moderator Dr. John Kane discuss the importance of monitoring for drug-induced movement disorders and thus the value of this DVD. As well, view clips from the DVD at cpnp.org/dvd and take advantage of advance purchase pricing for the DVD through the end of February 2012 at this same link.