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Tag: complex continuing care

The Example of Baclofen and Dantrolene: DISCUSSION part 2

The limitations of this study included the small sample size and the variation in disease states and symptom severity. This variation made it impossible to analyze any predictors of successful withdrawal. The lack of appropriate, validated, and reliable spasticity evaluation scales applicable to all disease states makes it difficult to assess the effectiveness of therapy […]

The Example of Baclofen and Dantrolene: DISCUSSION

A majority (81%) of the eligible patients who consented to participate in baclofen and dantrolene withdrawal were able to stop or minimize the dose ofthe medication; some patients experienced improvement in associated side effects. These results are similar to those seen in the earlier cisapride withdrawal project and confirm that periodic attempts to stop medications […]

The Example of Baclofen and Dantrolene: RESULTS

Patient enrollment began in November 2002, and all eligible patients had completed the withdrawal protocol and monitoring period by July 2004. At the time the project was started, 69 patients in the 348-bed complex continuing care unit were taking either baclofen or dantrolene or both. Twenty-nine of these patients were excluded from the study primarily […]

The Example of Baclofen and Dantrolene: METHODS part 2

Potential subjects for the study were identified from pharmacy medication records. Patients were considered eligible if they were receiving either baclofen or dantrolene or both. It was initially thought that the study should exclude any patients who had had recent (in the previous 6 months) dose changes of baclofen or dantrolene, a switch from one […]

The Example of Baclofen and Dantrolene: METHODS

A withdrawal protocol template, involving weekly 50% dose reductions at the discretion of the clinical teams, was developed for both baclofen and dantrolene. The proposed monitoring parameters included but were not limited to the following: • a measure of spasticity (e.g., Ashworth score, clonus score) • assessment of pain (e.g., rating of pain, on a […]

The Example of Baclofen and Dantrolene: INTRODUCTION part 2

In addition to the lack of objective evidence for effectiveness, antispasticity agents are associated with significant side effects. The common side effects of baclofen include drowsiness, vertigo, psychiatric disturbances, insomnia, slurred speech, ataxia, hypotonia, and weakness. These side effects are dose related, and elderly patients are at higher risk, particularly for side effects affecting the […]

The Example of Baclofen and Dantrolene

INTRODUCTION This article describes the outcomes of a tapering protocol for withdrawal of baclofen and dantrolene that is used in the Complex Continuing Care Program at the authors’ institution. The SCO Health Service in Ottawa, Ontario, has 348 complex continuing care beds, 98 rehabilitation beds, 36 palliative care beds, and 269 long-term care beds. Patients […]