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Published recently in European Neurological Review, the peer-reviewed journal from touchNEUROLOGY, David Bowers et al, highlight that, despite substantial impact on patients' independence and burden on caregivers, there is a lack of consensus on optimal management of spastic paresis and the patient journey remains unclear. A group of physicians, experienced in spasticity management, recently convened with the objective of analysing the patient journey from a care pathway perspective in different geographical regions and under different conditions from acute phase to long-term/chronic disease status. The experts reviewed results from recent patient and healthcare practitioner surveys on the subject and assessed how current patient pathways could be improved, using their own experiences to highlight the issues related to management deficiencies in their individual countries. The group divided the patient journey into steps, considering the evidence from the point of view of healthcare practitioners, patients, caregivers and funders/payors. This paper is a response to the lack of consensus on the optimal management of spastic paresis, and acts as a call to action to develop a consistent care pathway that could be applied across a broad range of illnesses, using an interdisciplinary approach.
The full peer-reviewed, open-access article is available here:
Disclosure: David Bowers has participated in an advisory board for Ipsen and has been a trainer for Allergan and Medtronic. Klemens Fheodoroff has received unrestricted research grants from Ipsen and Merz, and honoraria for instructional courses from Ipsen, Allergan and Merz. Patricia Khan has participated in advisory boards for Ipsen, and has received honoraria for instructional courses from Ipsen and Allergan. Julian P Harriss has received research funding into current practice in spasticity management (the SPACE study, supported by Merz Pharma) and expenses for participation in expert panels (Ipsen). Khashayar Dashtipour has received compensation/honoraria for services as a consultant or an advisory committee member or speaker from Allergan, Inc., Ipsen Biopharmaceuticals, Inc., Lundbeck Inc., Merz Pharmaceuticals, Teva Pharmaceutical Industries Ltd., UCB Inc., Impax Pharmaceutical and US World Meds. Laxman Bahroo has received personal compensation from Teva Neuroscience, UCB pharma, Impax, Allergan, Ipsen, US World Meds, AbbVie, Lundbeck and Acadia for consulting, serving on a scientific advisory board or speaking activities, and research support from Ipsen and Teva Neuroscience. Michael Lee has participated in an advisory board for Ipsen. Denis Zakharov has received personal compensation from Ipsen and Merz for consulting, serving on a scientific advisory board or speaking activities. Jovita Balcaitiene is an employee of Ipsen Pharma. Virgilio Evidente has received research support from Ipsen and honoraria for consulting and/or speaking from Ipsen, Merz, Solstice, US WorldMeds, Lundbeck, UCB, Xenoport, Teva, Medtronic and Acadia. This article involves a review of a meeting and did not involve any studies with human or animal subjects performed by any of the authors.
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