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Poster 27 Analyzing the Patient Journey for Patients Living with Spastic Paresis

  • David Bowers
  • , Patricia Khan
  • , Khashayar Dashtipour
  • , Laxman Bahroo
  • , Michael Y. Lee
  • , Jovita Balcaitiene
  • , Virgilio Evidente

Research output: Contribution to conferencePosterpeer-review

Abstract

Objective: To identify international barriers to optimal management of spastic paresis, and to recommend strategies for overcoming them. Design: Literature review and analysis, supplemented with the authors' personal clinical experiences, focusing on the current patient pathway - from diagnosis to long-term rehabilitation - of spastic paresis caused by damage to the brain or spinal cord. Setting: All healthcare settings. Participants: Healthcare professionals with experience in treating spastic paresis. Interventions: Not applicable Main Outcome Measures: Development of robust guidance for all stakeholders (healthcare practitioners, patients, caregivers, and payors) involved in the treatment of spastic paresis. Results or Clinical Course: Barriers to optimal management of spastic paresis were identified as the absence of global guidelines on its management, financial and logistical restrictions on access to treatment in some countries, lack of educational resources for stakeholders, and under use of injectable therapies such as botulinum toxin-A (BoNT-A) to relieve symptoms of spasticity. BoNT-A therapy has been proven to be effective and well tolerated in the treatment of spasticity, and careful monitoring and timely use of BoNT-A in conjunction with other treatment is crucial for effective management. The authors developed a 3-step process highlighting the role of all stakeholders along the patient pathway and recommendations. Better understanding of the relationship between underlying etiology and spastic paresis, and an awareness of gaps in service provision can help physicians and patients/caregivers navigate their treatment journey. Education will help to ensure that spasticity is recognized early and patient-centered treatment goals are set to encourage patients to take an active role in the treatment process. Conclusion: Specific guidelines for the comprehensive treatment of patients with spastic paresis and a coordinated effort from all stakeholders are needed to deliver optimal care and to overcome financial barriers from diagnosis through to long-term management. Patientcentered goal-setting and appropriate therapies, including guided self-rehabilitation, are important elements of the patient journey.
Original languageAmerican English
DOIs
StatePublished - Sep 1 2015
Externally publishedYes

Disciplines

  • Physical Therapy
  • Rehabilitation and Therapy
  • Medicine and Health Sciences

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