Poststroke Care Pathways and Spasticity Treatment: A Retrospective Study in Alberta

Area of Science:

• Neurology
• Rehabilitation Medicine
• Health Services Research

Background:

• Limited evidence exists on care pathways for stroke survivors regarding poststroke spasticity (PSS) treatment.
• Understanding these pathways is crucial for improving patient outcomes.

Purpose of the Study:

• To describe and compare the healthcare pathways of stroke survivors who initiated poststroke spasticity (PSS) treatment versus those who did not.
• To identify key healthcare settings and timing of interventions within these pathways.

Main Methods:

• A population-based cohort study using administrative data from Alberta, Canada (2012-2017).
• Identified adults with stroke and categorized them into PSS treatment and non-PSS treatment groups.
• Analyzed healthcare encounters, timing of spasticity treatment initiation, and treatment settings.

Main Results:

• The PSS treatment group (n=1,079) and non-PSS treatment group (n=22,922) both frequently accessed emergency departments and acute inpatient care.
• PSS treatment was initiated a median of 291 days post-stroke, most commonly in the community (45%).
• Inpatient rehabilitation was utilized by 40% of the PSS treatment group compared to 12% of the non-PSS treatment group.

Conclusions:

• This is the first population-based study detailing care pathways for adults with and without PSS treatment post-stroke.
• Significant delays in PSS treatment initiation were observed.
• Opportunities exist to enhance PSS care through earlier identification and treatment strategies.