Post-Stroke Spasticity Treatment: A Retrospective Cohort Study From Alberta, Canada

Area of Science:

• Neurology
• Rehabilitation Medicine
• Pharmacology

Background:

• Post-stroke spasticity (PSS) significantly impacts patient recovery and quality of life.
• Understanding current PSS treatment patterns is crucial for optimizing clinical practice and patient care.

Purpose of the Study:

• To analyze the real-world utilization of PSS treatments in Alberta, Canada.
• To identify patterns in treatment initiation, timing, and prescriber types for PSS.

Main Methods:

• Retrospective cohort study utilizing population-level administrative data from 2012-2019.
• Identified adults initiating PSS treatment (clinic visit, botulinum toxin, or specific medications).
• Measured treatment use, time to start, and physician specialty; descriptive statistics were applied.

Main Results:

• Oral baclofen was the most common initial PSS treatment (60.9%), largely prescribed by primary care physicians.
• Focal botulinum toxin injections (23.3%) were mainly prescribed by physiatrists.
• Treatments were initiated a median of 311-348 days post-stroke, indicating potential delays.

Conclusions:

• Evidence suggests gaps in PSS management, including potential overuse of oral baclofen and underuse of focal botulinum toxin.
• Current PSS treatment patterns may not align with evidence-based guidelines.
• Further strategies are needed to improve PSS care and enhance patient outcomes.