Frequency and Determinants of Using Pharmacological Enhancement in the Clinical Practice of In-Hospital Stroke Rehabilitation

被引:21
作者
Engelter, Stefan T. [1 ,2 ,3 ]
Urscheler, Niklaus [4 ]
Baronti, Fabio [5 ]
Vuadens, Philippe [6 ]
Koch, Joachim [7 ]
Frank, Matthias
Disserens, Karin [8 ]
Jenni, Walter [9 ]
机构
[1] Felix Platter Hosp, Abt Neurorehabil, Neurorehabil Unit, Geriatr Competence Ctr, CH-4055 Basel, Switzerland
[2] Univ Basel Hosp, Stroke Unit, CH-4031 Basel, Switzerland
[3] Univ Basel Hosp, Dept Neurol, CH-4031 Basel, Switzerland
[4] Reha Rheinfelden, Rheinfelden, Switzerland
[5] Klin Bethesda Tschugg, Tschugg, Switzerland
[6] Clin Romande Readaptat, Sion, Switzerland
[7] Rehazentrum Leukerbad, Leukerbad, Switzerland
[8] CHU Vaudois, Early Neurorehabil Unit, Dept Clin Neurosci, Lausanne, Switzerland
[9] RehaClin Zurzach, Zurzach, Switzerland
关键词
Pharmacological enhancement; PESR; utilization rates; In-hospital stroke rehabilitation; DOUBLE-BLIND; CONTROLLED-TRIAL; MOTOR RECOVERY; PHYSIOTHERAPY; LEVODOPA; APHASIA; THERAPY; PHARMACOTHERAPY; METHYLPHENIDATE; BROMOCRIPTINE;
D O I
10.1159/000335895
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Pharmacological enhancement in stroke rehabilitation (PESR) is promising. Data about its use in clinical practice are missing. Methods: In a prospective, explorative study of four rehabilitation centers, we systematically observed the frequency and determinants of using PESR in consecutive patients. PESR was defined as using agents potentially enhancing post-stroke recovery exclusively to aid rehabilitation without an established indication. Results: 257 (55.4%) of 464 patients had agents potentially enhancing recovery. Selective serotonin reuptake inhibitors (SSRI) (n = 125, 26.9%), levodopa (n = 114, 24.6%), serotonin-noradrenaline reuptake inhibitors (SNRI) (n = 52, 11.2%), and acetylcholinesterase inhibitors (n = 48, 10.3%) were used most often. SSRI in 102/125 patients and SNRI in 46/52 patients were mostly used for accompanying depressive symptoms. 159 (34.3%) patients had PESR (without an otherwise established indication). In PESR patients, levodopa (n = 102, 64.1%) was used most commonly. PESR was primarily used for aphasia (36.5%) and paresis (25.2%). PESR patients did not differ from non-PESR patients in age, gender and stroke type. However, the utilization rates of PESR differed significantly across centers (2, 4, 38 and 55%). Conclusion: SSRI and SNRI were predominately used for accompanying depression, while levodopa was nearly exclusively used to aid stroke rehabilitation in the absence of an otherwise established indication. The differences in utilization rates for PESR between centers suggest therapeutic uncertainty and indicate the need for additional studies. Copyright (C) 2012 S. Karger AG, Basel
引用
收藏
页码:28 / 33
页数:6
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