Patients stated that they were highly satisfied with the ITB treatment. However, the patients identified several areas that could be improved. Specifically, the patients wanted more information about the different steps in the treatment process and what to expect from ITB treatment.

Most patients/proxies reported a high level of satisfaction with intrathecal baclofen treatment. The reported satisfaction with intrathecal baclofen treatment was not dependent on general expectations. Implications for Rehabilitation Patients with intrathecal baclofen treatment report low levels of health and quality of life at the same time as they are highly satisfied with their treatment. Intrathecal baclofen should be equally offered to both optimistic and less optimistic patients. Patients who are able to/not able to communicate, differs in characteristics and should be informed and followed up in different ways in daily clinical practice.

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Purpose: The aim of this study was to describe and analyze dosing patterns for patients with ITB treatment over time and to identify possible subgroups demonstrating diversity in patterns. Design: A retrospective design. Methods: For 81 patients from six different hospitals, baclofen doses from the first 2 years of treatment were identified using medical records. Line graphs of each patient's doses were analyzed and grouped based on similarities in dosing pattern. Findings: The analyses of the dosing patterns resulted in four different subgroups classified as stable, slow increase, rapid increase, and fluctuating. Conclusion:The results highlight the clinical challenge of predicting dose development over time. Clinical Relevance to Rehabilitation Nursing: This study provides rehabilitation healthcare professionals with a better understanding of intrathecal baclofen dose development. Illustrations of the four subgroups can be used as an educational tool for patients, family, and caregivers.

Objective: To investigate patients’ expectations, met/unmet expectations and satisfaction with intrathecal baclofen treatment in relation to effect on spasticity, pain intensity, sleep quality, occupational performance, well-being and self-efficacy.Design: A prospective longitudinal study with follow-up at 1 year.Patients: Consecutive patients, age ≥ 18 years with a disabling spasticity of cerebral or spinal origin selected for intrathecal baclofen treatment at 2 university hospitals in Sweden were included. From August 2016 to June 2019, 35 patients began intrathecal baclofen treatment; 29 patients were included and completed the study.Methods: Baseline and 1-year follow-up included assessment of spasticity by physiotherapists, a semi-structured interview regarding occupational performance using the Canadian Occupational Performance Measure and a questionnaire.Results: Overall satisfaction with treatment and satisfaction with occupational performance were reported as moderate. Important variables that explained satisfaction with occupational performance were improvements in performance, expectations and performance before treatment. Patients had higher expectations compared with the 1-year outcomes regarding occupational performance, spasticity, pain intensity and sleep quality, although improvements were reported.Conclusion: A thorough discussion of goal setting with intrathecal baclofen treatment before implantation is necessary to give patients individual and realistic expectations. LAY ABSTRACTSpasticity is a common complication for patients with various neurological conditions, such as spinal cord injury, acquired brain injury, cerebral palsy and multiple sclerosis. For patients with disabling spasticity, intrathecal baclofen is an effective and satisfactory treatment. Dissatisfaction with treatment has been described, but has not been thoroughly evaluated. Therefore, this study examined patients’ expectations of effects on occupational performance, spasticity, pain intensity and sleep quality. Patients were followed-up after 1 year on the treatment, and results and satisfaction were reported. Patients improved, but not as much as they had expected. As a group, they were moderately satisfied, and important variables for satisfaction were found to be improvements in performance, expectations and initial performance. These results highlight the need to discuss patients’ expectations and goals with this treatment even more thoroughly and to address realistic expectations.