Faculty Collaboration Database

Intrathecal Baclofen Dosing Regimens: A Retrospective Chart Review. Neuromodulation 2016 Aug;19(6):642-9

Date

10/31/2015

Pubmed ID

26517855

DOI

10.1111/ner.12361

Scopus ID

2-s2.0-84981747156 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

OBJECTIVES: To examine dosing patterns in patients receiving baclofen via intrathecal baclofen pumps to assess for common patterns by diagnosis, ambulation ability, and affected limbs distribution.

MATERIALS AND METHODS: This trial study included 25 patients with baclofen pumps selected from the 356 patients enrolled in our center's baclofen pump program. Selection was done by splitting all patients into diagnostic categories of stroke, multiple sclerosis, traumatic/anoxic brain injury, cerebral palsy, and spinal cord injury, and then, five patients were randomly selected from each diagnosis.A systematic chart review was then conducted for each patient from Jan 1, 2008, through September 16, 2013, to look at factors including mean daily dose at end of study, and among those implanted during the study mean initial stable dose and time to initial stable dose.

RESULTS: Analysis of mean daily dose across diagnoses found significant differences, with brain injury, cerebral palsy, and spinal cord injury patients having higher doses while multiple sclerosis and stroke patients required lower doses. Nonambulatory patients strongly trended to have higher daily doses than ambulatory patients. Similar trends of mean initial stable dose being higher in a similar pattern as that of end mean daily dose were seen according to diagnoses and ambulatory status, although statistical significance could not be achieved with the small sample size.

CONCLUSION: Significant differences in dosing were found between diagnoses and trended to differ by ambulatory status at the end of the study, and similar trends could be observed in achieving initial stable dose.

Author List

Clearfield JS, Nelson ME, McGuire J, Rein LE, Tarima S

Authors

Mary Elizabeth S. Nelson-Biersach DNP, NP Assistant Professor Outpatient in the Physical Medicine and Rehabilitation department at Medical College of Wisconsin
Lisa E. Rein Biostatistician III in the Institute for Health and Equity department at Medical College of Wisconsin
Sergey S. Tarima PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Baclofen
Brain Injuries
Cerebral Palsy
Dose-Response Relationship, Drug
Female
Humans
Infusion Pumps, Implantable
Injections, Spinal
Male
Middle Aged
Multiple Sclerosis
Muscle Relaxants, Central
Muscle Spasticity
Retrospective Studies
Severity of Illness Index
Spinal Cord Injuries
Stroke
Treatment Outcome