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Neuropediatrics 2020; 51(02): 129-134
DOI: 10.1055/s-0040-1701659
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Access to Intrathecal Baclofen Treatment for Children with Cerebral Palsy in European Countries: An SCPE Survey Reveals Important Differences

Kate Himmelmann 
1   Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
2   Regional Rehabilitation Centre, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
,
Magnus Påhlman
2   Regional Rehabilitation Centre, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
,
Guro L. Andersen
3   The Cerebral Palsy Register of Norway, Vestfold Hospital Trust, Tönsberg, Norway
,
Torstein Vik
4   Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
,
Daniel Virella
5   The Cerebral Palsy Registry of Portugal, Área da Mulher, Criança e Adolescência, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
,
Karen Horridge
6   Paediatric Department, Sunderland Royal Hospital, Sunderland, United Kingdom
7   The North of England Collaborative Cerebral Palsy Survey, Regional Maternity Survey Office, Public Health England, Newcastle upon Tyne, United Kingdom
,
David Neubauer
8   Department of Pediatric Neurology, University Children's Hospital, Ljubljana, Slovenia
,
Catherine Arnaud
9   UMR 1027 Inserm U, Toulouse III University, Toulouse, France
10   Clinical epidemiology Unit, University Hospital, Toulouse, France
,
Gija Rackauskaite
11   Child and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
,
Javier de la Cruz
12   Clinical Research Unit, Imas12-Ciberesp, Hospital 12 Octubre, Madrid, Spain
› Author Affiliations Acknowledgments This study was performed on behalf of the SCPE collaboration and was funded by the European Union Health Program—Grant Number DG SANCO EAHC 2008 1307—“Surveillance of Cerebral Palsy in Europe: best practice in monitoring, understanding of inequality, and dissemination of knowledge.”
We are grateful to all centers across Europe contributing data to this study.
Medtronic, Tricumed, and Codman manufacturers of medical pumps used for intrathecal baclofen treatment, provided information regarding availability of treatment in European countries.
Further Information

Publication History

16 April 2019

09 December 2019

Publication Date:
02 March 2020 (online)

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Abstract

Aim The aim is to study access to intrathecal baclofen (ITB) for children with cerebral palsy (CP) in Europe, as an indicator of access to advanced care.

Methods Surveys were sent to CP registers, clinical networks, and pump manufacturers. Enquiries were made about ITB treatment in children born in 1990 to 2005 by sex, CP type, level of gross motor function classification system (GMFCS) and age at the start of treatment. Access to ITB was related to the country's gross domestic product (GDP) and % GDP spent on health.

Results In 2011 population-based data from Sweden, Norway, England, Portugal, Slovenia, and Denmark showed that 114 (3.4%) of 3,398 children with CP were treated with ITB, varying from 0.4 to 4.7% between centers. The majority of the children were at GMFCS levels IV-V and had bilateral spastic CP. In Sweden, dyskinetic CP was the most commonly treated subtype. Boys were more often treated with ITB than girls (p = 0.014). ITB was reported to be available for children with CP in 25 of 43 countries. Access to ITB was associated with a higher GDP and %GDP spent on health (p < 0.01). Updated information from 2019 showed remaining differences between countries in ITB treatment and sex difference in treated children was maintained.

Conclusion There is a significant difference in access to ITB for children with CP across Europe. More boys than girls are treated. Access to ITB for children with CP is associated with GDP and percent of GDP spent on health in the country.

Keywords

cerebral palsy - intrathecal baclofen - survey - advanced care - children

Supplementary Material

 

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