Medication, rehabilitation and health care consumption in adults with cerebral palsy: a population based study

Pons, Christelle; Brochard, Sylvain; Gallien, P.; Nicolas, B.; Duruflé, A.; Roquet, M.; Rémy-Néris, Olivier; Garlantézec, Ronan

doi:10.1177/0269215516663286

Cited by 15 publications

(31 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…MR service use, especially PT, was reported by almost all participants, even if the rate was slightly lower in adults. This result was expected since, in France, PT is traditionally prescribed, and now recommended ( 28 ), as a first-line therapy; it is also consistent with a previous study of adults with CP in a region of France ( 29 ). The detailed analysis showed that the amount of weekly physiotherapy provided was lower in young adults than in children and adolescents, and decreased further after the age of 25 years.…”

Section: Discussionsupporting

confidence: 90%

The Use and Outcomes of Motor Rehabilitation Services Among People With Cerebral Palsy Change Across the Lifespan

Cornec

Brochard

Drewnowski³

et al. 2022

Front. Neurol.

Self Cite

View full text Add to dashboard Cite

Background and AimsThe provision of coordinated and multidisciplinary rehabilitation programs that adapt to the individual with cerebral palsy (CP) evolving rehabilitation needs throughout the different phases of life is highly challenging for healthcare systems. The aim of this study was to report the changes in motor rehabilitation (MR) environmental factors, service use and patient outcomes between children and adults with cerebral palsy and to identify if changes took place earlier or later than the standard division between pediatric and adult healthcare systems at 18 years.MethodsWe used data from the French ESPaCe survey to select a set of indicators for MR environmental factors, service use and patient outcomes, highlighted by patients and families in previous studies. We then compared the distribution of the indicator data between children and adults, as well as between four transition age groups: children under 12, adolescents up to 17 years, young adults, and adults over 25 years of age. We estimated odds ratios adjusted for motor involvement, associated impairments and informant type.ResultsA total of 997 respondents over 2 years of age were included in this study (484 children and 513 adults). Finding an available physiotherapist was very difficult for almost half of the children, and a greater proportion of adolescents and adults. Physiotherapy was provided in a private outpatient practice for twice as many adults over 25 years as children and adolescents. The weekly amount of physical therapy decreased as outpatient practice increased. Multidisciplinary rehabilitation decreased sharply from adolescence and was halved at adulthood. Satisfaction with the MR program decreased from childhood into adolescence and adulthood. Perceived impact of physiotherapy on people with CP and their main carers were less positive in adolescents.ConclusionsHealthcare policies should focus on accessibility issues at all ages, consider adolescents as a specific population, consider a wide transition phase (12–25 yo) and maintain a multidisciplinary approach at adulthood. There is a strong need for national rehabilitation strategies for individuals with CP.

show abstract

Section: Discussionsupporting

confidence: 90%

The Use and Outcomes of Motor Rehabilitation Services Among People With Cerebral Palsy Change Across the Lifespan

Cornec

Brochard

Drewnowski³

et al. 2022

Front. Neurol.

Self Cite

View full text Add to dashboard Cite

show abstract

“…Moreover, we need to investigate pain J o u r n a l P r e -p r o o f management and treatment, such as approaches of therapy and surgery, and pharmacological treatment [50,51]. Use of medication is known to increase with age, and high levels of medication are prone to the risk of polypharmacy [52]. Furthermore, long-term effects could be studied in follow-up programs (e.g., CP registries) continuing into adult age [41].…”

Section: Discussionmentioning

confidence: 99%

Pain in adults with cerebral palsy: A systematic review and meta-analysis of individual participant data

Slot

Benner

Brunton

et al. 2021

Annals of Physical and Rehabilitation Medicine

Self Cite

View full text Add to dashboard Cite

Background. There is little focus on adults with cerebral palsy (CP) in research and health care and insufficient knowledge on how to identify and manage pain in this population.J o u r n a l P r e -p r o o f 2 Objectives. This systematic review and meta-analysis aimed to determine whether pain prevalence in adults with CP is high and to explore variations in pain prevalence of subgroups, pain locations, pain severity and pain interference. Methods. Potential datasets were identified by experts in the field and literature searches in Embase, MEDLINE, and Cochrane, from January 2000 to October 2016. Included studies had a representative sample of ≥ 25 adults with CP and ≥ 1 pain outcomes. Methodological quality assessment, pain prevalence estimates and logistic regression models for subgroup effects on pain prevalence were conducted. Results. In total, 17 eligible studies were identified from 4584 publications. A meta-analysis was performed with individual participant data from 15 studies totalling 1243 participants (mean [SD] age 34.3 [12.6] years). Overall mean pain prevalence was 70% (95% CI 62-78).Women were more likely to have pain than men (P<0.001). The odds of pain was increased in adults with gross motor function level II (odds ratio [OR] 1.92, 95% CI 1.22-3.12) and IV (OR 1.77, 95% CI 1.03-4.29). Participants with pain reported pain predominantly in the legs (76%, 95% CI 66-84), and mean pain severity was 3.7/10 (95% CI 2.7-4.7) and pain interference 3.5/10 (95% CI 2.5-4.5).Conclusions. This meta-analysis provides the first reliable pain prevalence estimate in a large international sample of adults with CP. The high prevalence of pain, 70%, suggests that adults with CP should be routinely screened for pain and treated accordingly. The range of measurement instruments used by the included studies emphasizes using common outcome measures specific to pain internationally.

show abstract

“…Nine studies reported factors associated with health service use. 9,33,35,36,42,44,48,51,52 Sex and ethnicity were related to health service use: females had higher rates of service use compared to males 33,36,48 and adults from ethnic minority groups were less likely to be hospitalized or attend the emergency department compared to those of white ethnicity. 42 Those receiving national basic livelihood security/ medical aid in the Republic of Korea were more likely to have frequent hospital visits, periodic medical follow-ups, and rehabilitation treatment compared to adults not receiving aid.…”

Section: Factors and Outcomes Associated With Health Service Usementioning

confidence: 99%

“…9,35 Pooled analysis of seven studies indicated that 44% (95% CI: 36-51%; I 2 =70.2%; p<0.01) of adults visited a physiotherapist over 12 months. 23,24,26,[50][51][52][53] The proportion of adults visiting physiotherapy services over other or unspecified time-periods 9,10,35,36,41 varied from 28% to 87%. Hippotherapy and hydrotherapy services were used by 9% and 28% of adults respectively.…”

Section: Rehabilitation Servicesmentioning

confidence: 99%

Health service use among adults with cerebral palsy: a mixed‐methods systematic review

Manikandan

Kerr²,

Lavelle

et al. 2021

Develop Med Child Neuro

View full text Add to dashboard Cite

Aim To determine the proportion of adults with cerebral palsy (CP) using health services and frequency of use, and to explore experiences and perceptions of health services for this population. Method A mixed‐methods systematic review was conducted using the Joanna Briggs Institute methodology. Five databases were searched to September 2020. Observational and qualitative studies were included. Two reviewers screened titles, abstracts, and full texts; extracted data; and assessed the quality of included studies. Separate meta‐analyses were used to pool the proportion of adults using each service and frequency of use. A meta‐aggregation approach was used to synthesize qualitative data. Quantitative and qualitative findings were integrated using the Andersen and Newman Model of health care utilization. Results Fifty‐seven studies (31 quantitative, 26 qualitative) of 14 300 adults with CP were included. The proportion of adults using services ranged from 7% (95% confidence interval [CI]: 2–13%) for urologists to 84% (95% CI: 78–90%) for general practitioners. Incidence of visits ranged from 67 (95% CI: 37–123) hospital admissions to 404 (95% CI: 175–934) general practitioner visits per 100 person‐years. Qualitative themes highlighted issues regarding accessibility, caregivers’ involvement, health workers’ expertise, unmet ageing needs, transition, and health system challenges. Interpretation Adults with CP used a wide range of health services but faced context‐specific challenges in accessing required care. Appropriate service delivery models for adults with CP are required. This review emphasizes a need to develop an appropriate service model for adults with CP to meet their needs.

show abstract

Medication, rehabilitation and health care consumption in adults with cerebral palsy: a population based study

Cited by 15 publications

References 54 publications

The Use and Outcomes of Motor Rehabilitation Services Among People With Cerebral Palsy Change Across the Lifespan

The Use and Outcomes of Motor Rehabilitation Services Among People With Cerebral Palsy Change Across the Lifespan

Pain in adults with cerebral palsy: A systematic review and meta-analysis of individual participant data

Health service use among adults with cerebral palsy: a mixed‐methods systematic review

Contact Info

Product

Resources

About