Evaluating Community-Based Intrathecal Baclofen Therapy: Effectiveness, Safety, and Feasibility
<b>Background:</b> Intrathecal baclofen (ITB) is used for the treatment of intractable spasticity. The burden of traveling for ITB screening and aftercare is problematic for nursing home residents with severe spasticity and seems to result in undertreatment of spasticity. The aim of this...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/7/1840 |
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| author | Simone M. E. van der Gaag Sander P. G. Frankema Eva S. van der Ploeg Sara J. Baart Frank J. M. P. Huygen |
| author_facet | Simone M. E. van der Gaag Sander P. G. Frankema Eva S. van der Ploeg Sara J. Baart Frank J. M. P. Huygen |
| author_sort | Simone M. E. van der Gaag |
| collection | DOAJ |
| description | <b>Background:</b> Intrathecal baclofen (ITB) is used for the treatment of intractable spasticity. The burden of traveling for ITB screening and aftercare is problematic for nursing home residents with severe spasticity and seems to result in undertreatment of spasticity. The aim of this study is to evaluate the effectiveness, safety, and feasibility of ITB for nursing home residents treated in their home, describing the selection phase, the initial trial of ITB, and aftercare up to 3 months after implantation of an ITB pump. <b>Methods</b>: This retrospective database study included immobile, adult nursing home residents with severe spasticity, referred to an Ambulatory Care Clinic between 2016 and 2021. When eligible, an ITB trial was performed by ITB experts in the nursing home. If a permanent pump was implanted, dose titration and aftercare were performed on location. <b>Results</b>: A total of 102 patients were referred; 80 underwent an ITB trial on location, and 94% improved significantly on the Modified Ashworth Scale and clonus scale pre-ITB trial versus post-ITB trial, as well as at 3 months post-implantation. There was a low incidence of adverse events, mostly procedure- and drug-related. <b>Conclusions</b>: This study indicates that selection, testing, and aftercare for ITB on location is effective and safe. |
| first_indexed | 2024-04-24T10:42:09Z |
| format | Article |
| id | doaj.art-3f0e84fe5ec648f6886e25231acea95a |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-04-24T10:42:09Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-3f0e84fe5ec648f6886e25231acea95a2024-04-12T13:20:48ZengMDPI AGJournal of Clinical Medicine2077-03832024-03-01137184010.3390/jcm13071840Evaluating Community-Based Intrathecal Baclofen Therapy: Effectiveness, Safety, and FeasibilitySimone M. E. van der Gaag0Sander P. G. Frankema1Eva S. van der Ploeg2Sara J. Baart3Frank J. M. P. Huygen4Ambulatory Care Clinic, Care4homecare, Rond Deel 12, 5531 AH Bladel, The NetherlandsCenter for Pain Medicine, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The NetherlandsAmbulatory Care Clinic, Care4homecare, Rond Deel 12, 5531 AH Bladel, The NetherlandsCenter for Pain Medicine, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The NetherlandsCenter for Pain Medicine, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands<b>Background:</b> Intrathecal baclofen (ITB) is used for the treatment of intractable spasticity. The burden of traveling for ITB screening and aftercare is problematic for nursing home residents with severe spasticity and seems to result in undertreatment of spasticity. The aim of this study is to evaluate the effectiveness, safety, and feasibility of ITB for nursing home residents treated in their home, describing the selection phase, the initial trial of ITB, and aftercare up to 3 months after implantation of an ITB pump. <b>Methods</b>: This retrospective database study included immobile, adult nursing home residents with severe spasticity, referred to an Ambulatory Care Clinic between 2016 and 2021. When eligible, an ITB trial was performed by ITB experts in the nursing home. If a permanent pump was implanted, dose titration and aftercare were performed on location. <b>Results</b>: A total of 102 patients were referred; 80 underwent an ITB trial on location, and 94% improved significantly on the Modified Ashworth Scale and clonus scale pre-ITB trial versus post-ITB trial, as well as at 3 months post-implantation. There was a low incidence of adverse events, mostly procedure- and drug-related. <b>Conclusions</b>: This study indicates that selection, testing, and aftercare for ITB on location is effective and safe.https://www.mdpi.com/2077-0383/13/7/1840spasticityneuromodulationambulatory careintrathecal baclofenscreeningITB trial |
| spellingShingle | Simone M. E. van der Gaag Sander P. G. Frankema Eva S. van der Ploeg Sara J. Baart Frank J. M. P. Huygen Evaluating Community-Based Intrathecal Baclofen Therapy: Effectiveness, Safety, and Feasibility Journal of Clinical Medicine spasticity neuromodulation ambulatory care intrathecal baclofen screening ITB trial |
| title | Evaluating Community-Based Intrathecal Baclofen Therapy: Effectiveness, Safety, and Feasibility |
| title_full | Evaluating Community-Based Intrathecal Baclofen Therapy: Effectiveness, Safety, and Feasibility |
| title_fullStr | Evaluating Community-Based Intrathecal Baclofen Therapy: Effectiveness, Safety, and Feasibility |
| title_full_unstemmed | Evaluating Community-Based Intrathecal Baclofen Therapy: Effectiveness, Safety, and Feasibility |
| title_short | Evaluating Community-Based Intrathecal Baclofen Therapy: Effectiveness, Safety, and Feasibility |
| title_sort | evaluating community based intrathecal baclofen therapy effectiveness safety and feasibility |
| topic | spasticity neuromodulation ambulatory care intrathecal baclofen screening ITB trial |
| url | https://www.mdpi.com/2077-0383/13/7/1840 |
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