title: A self-report of quality of life of patients receiving intrathecal baclofen therapy.
abstract: The purpose of this study was to explore through a department quality improvement tool a possible relation between quality of life (QOL), complication rates, and length of intrathecal baclofen (IB) treatment as reported by patients receiving IB therapy in a community-based rehabilitation center outpatient clinic. A second objective was to examine complication rates among the clinic's patients. No conclusions could be drawn as to the relation between QOL, various reported complications, and length of treatment. A rank order frequency of areas reported by respondents to have the greatest impact on their QOL could be extrapolated from the data collected. In addition, complication rates among the patients who responded to the survey could be reported. Surveys from 49 patients about their experiences with IB therapy were analyzed. Respondents included 30 adult and 19 pediatric patients. Thirty-six patients (73%) had used the IB pump for 1 year or more. The survey included questions about QOL, complications, and length of IB treatment. Forty-three respondents (88%) stated they felt that their QOL had improved with IB therapy. Four patients (8%) responded that they were not sure that it had, and only 2 patients (4%) said that IB had not improved their QOL. The most frequently reported positive effects on QOL were reported in the following areas: spasticity control without the sedative effect of oral medication; ease of care for caregivers; easier positioning; less pain/increased comfort; and improved patient transfers. High ratings of improvement in the patients' QOL were reported despite a reported overall complication rate of 39%. The most common complications cited were infection and catheter breakage or disconnect. The overall infection rate for respondents was 10% (5 patients of the 49 surveyed reported infection). The rate of catheter breakage or disconnect was also 10%. Despite the complications reported, 46 patients stated they would recommend baclofen treatment to others. Three patients did not respond to the question. None of the patients said they would not recommend baclofen to others.
authors.affiliation: Center for Limb Differences, Mary Free Bed Hospital and Rehabilitation Center, 235 Wealthy Street, Grand Rapids, MI 49503, USA. cstaal@mfbrc.com
authors.forename: Collette
authors.initials: C
authors.lastname: Staal
authors.forename: Amy
authors.initials: A
authors.lastname: Arends
authors.forename: Sam
authors.initials: S
authors.lastname: Ho
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001418:Baclofen / Q000008:administration & dosage* / Q000009:adverse effects*; D002648:Child; D003151:Community Health Centers; D003428:Cross Infection / Q000209:etiology; D004868:Equipment Failure; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects* / Q000523:psychology; D007263:Infusions, Parenteral / Q000009:adverse effects; D008824:Michigan; D009125:Muscle Relaxants, Central / Q000008:administration & dosage* / Q000009:adverse effects*; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology / Q000451:nursing / Q000523:psychology*; D011788:Quality of Life; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D017749:Total Quality Management; D016896:Treatment Outcome
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen