Long-Term Care Resident Awareness and Interest in Spasticity Treatments.

Mallory L Hacker,Chandler E Gill,Amanda D Currie,Fenna T Phibbs,Maxim Turchan,David Charles,Michael S Putman,Taylor S Hudson

doi:10.3390/geriatrics6010021

Abstract

Spasticity is common in long-term care settings (affecting up to one in three residents), yet it remains under-treated despite safe and effective, Food and Drug Administration (FDA)-approved therapies. One barrier to treatment may be lack of awareness of available therapies for long-term care residents living with spasticity. A standardized spasticity treatment awareness and interest interview was conducted with 18 nursing home residents and 11 veterans’ home residents in this cross-sectional study. Veterans’ home residents were also asked about potential barriers to receiving spasticity treatment. Many residents across both long-term care facilities were unaware of most of the treatment options for spasticity. Participants were most aware of physical/occupational therapy (83%, 95% CI: 65–93%) and least aware of intrathecal baclofen (21%, 95% CI: 9–39%). After learning about treatments, only 7% of participants (95% CI: 0–23%) were not interested in receiving any form of spasticity treatment. Among residents previously unaware of spasticity treatments, at least one quarter became interested in receiving treatment and at least one-fifth indicated possibly being interested in the treatment after learning about it. Potential barriers to receiving treatment included traveling to see a doctor and limited knowledge of insurance coverage of spasticity treatments. These results suggest that patient-centered approaches, including education and discerning patient preferences, may improve spasticity treatment in long-term care settings.

Highlights

Spasticity affects up to one-third of residents in long-term care settings but remains largely undiagnosed and undertreated [1,2,3,4]
There are a variety of treatments available for spasticity, it remains under-treated in long-term care settings [1,2,3,4,12]
These results indicate that a large percent of residents with spasticity from two different long-term care settings are unaware of most of the available spasticity treatment options and that many are interested in the treatments once informed about them

Summary

Introduction

Spasticity affects up to one-third of residents in long-term care settings but remains largely undiagnosed and undertreated [1,2,3,4]. This velocity-dependent increase in stretch reflex associated with muscle hypertonicity arises following disease or injury to the central nervous system (e.g., stroke). Safe and efficacious treatments for spasticity include physical/occupational therapy, medications, and surgery. These treatments can enhance quality of life by improving care delivery and restoring ADL function [10,11]. One barrier to long-term care residents receiving spasticity treatment may be their lack of awareness of the range of available treatment options and their associated safety and efficacy profiles

Methods

Results

Discussion

Conclusion