title: Long-term intrathecal baclofen: outcomes after more than 10 years of treatment.
abstract: OBJECTIVE
  To report outcomes of intrathecal baclofen (ITB) therapy for spasticity management in a cohort of patients who had received this treatment for at least 10 years.
  
  
  METHODS
  A cross-sectional survey and retrospective chart review.
  
  
  METHODS
  An academic rehabilitation outpatient clinic.
  
  
  METHODS
  Adult patients with spasticity treated with ITB for at least 10 years.
  
  
  METHODS
  Surveys included the Brief Pain Inventory, Penn Spasm Frequency Scale, Epworth Sleepiness Scale, Fatigue Severity Scale, Diener Satisfaction with Life, Life Satisfaction Questionnaire, and Intrathecal Baclofen Survey.
  
  
  RESULTS
  Twenty-four subjects completed the surveys. The subjects had been treated with ITB from 10.0-28.4 years, with a mean (standard deviation) of 14.7 ± 4.2 years. The mean (standard deviation) dose of ITB was 627.9 ± 306.7 μg/d, with only 6 subjects averaging daily dose changes of more than 10% compared with 3 years earlier. The mean (standard deviation) scores on outcomes surveys were the following: 2.6 ± 2.3 for pain severity on the Brief Pain Inventory, 1.4 ± 0.7 for spasm severity on the Penn Spasm Frequency Scale, 7.9 ± 5.4 on the Epworth Sleepiness Scale, 4.1 ± 1.6 on the Fatigue Severity Scale, 19.4 ± 8.1 on the Diener Satisfaction with Life, 3.9 ± 0.9 on the Life Satisfaction Questionnaire, and 8.8 ± 1.9 for overall satisfaction with ITB on the Intrathecal Baclofen Survey. On the Brief Pain Inventory, the mean scores for pain severity and interference of pain with life showed moderate inverse correlations with ITB dose (r = -0.386, P = .115; and r = -0.447, P = .062, respectively). On the Life Satisfaction Questionnaire, the mean scores for life satisfaction showed statistically significant positive correlation with ITB dose (r = 0.549, P = .021).
  
  
  CONCLUSIONS
  The subjects reported low levels of pain, moderate levels of life satisfaction, normal levels of sleepiness, low-to-moderate levels of fatigue, infrequent spasms at mild-to-moderate severity, and high levels of satisfaction. The efficacy and favorable adverse effect profile of ITB therapy was sustained in this cohort of subjects with more than a decade of treatment.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Chicago, McGaw Medical Center, Northwestern University Feinberg School of Medicine, Chicago, IL(∗).
authors.forename: Sunjay N
authors.initials: SN
authors.lastname: Mathur
authors.affiliation: Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Chicago, McGaw Medical Center, Northwestern University Feinberg School of Medicine, Chicago, IL(†).
authors.forename: Samuel K
authors.initials: SK
authors.lastname: Chu
authors.affiliation: Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Chicago, 345 East Superior Street, Room 1610, Chicago, IL(‡). Electronic address: zmccormick@ric.org.
authors.forename: Zack
authors.initials: Z
authors.lastname: McCormick
authors.affiliation: Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Chicago, McGaw Medical Center, Northwestern University Feinberg School of Medicine, Chicago, IL(§).
authors.forename: George C
authors.initials: GC
authors.lastname: Chang Chien
authors.affiliation: Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Chicago, McGaw Medical Center, Northwestern University Feinberg School of Medicine, Chicago, IL(¶).
authors.forename: Christina M
authors.initials: CM
authors.lastname: Marciniak
mesh_terms: D000328:Adult; D000368:Aged; D001418:Baclofen / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004502:Education, Medical, Continuing; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007278:Injections, Spinal / Q000379:methods*; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen