Spinal Cord Injury
Quality Improvement and Implementation Science
Oral Presentation
Aaron L Ellenbogen, DO
Neurologist
Michigan Institute for Neurological Disorders
Farmington Hills, Michigan
Alberto Esquenazi, MD
Department Chair and Chief Medical Officer
MossRehab Gait and Motion Analysis Laboratory
Elkins Park, Pennsylvania
George F. Wittenberg, MD
Professor of Neurology and Director
VA Pittsburgh Healthcare System, University of Pittsburgh; and University of Maryland (at the time of the study)
Pittsburgh, Pennsylvania
Kenneth Ngo, MD
Associate Medical Director
Brooks Rehabilitation Hospital
Jacksonville, Florida
Joan Largent, PhD
Director, Epidemiology and Outcomes Research
IQVIA Real-World Evidence Solutions
Cambridge, Massachusetts
Aleksej Zuzek, PhD
Director, Medical Affairs
Allergan plc
Irvine, California
Gerard Francisco, MD
Department Chairman and Chief Medical Officer
University of Texas McGovern Medical School and TIRR Memorial Hermann
Houston, Texas
Wolfgang H. Jost, MD
Professor of Neurology
University of Freiburg, Parkinson-Klinik Ortenau
Wolfach, Baden-Wurttemberg
This abstract examines the real-world impact of onabotulinumtoxinA treatment in adult patients with spasticity on caregiver burden over 2 years from the Adult Spasticity International Registry (ASPIRE) study.
Objective : Examine the real-world impact of onabotulinumtoxinA treatment in adult patients with spasticity on caregiver burden over 2 years from the Adult Spasticity International Registry (ASPIRE) study.
Design : Prospective, observational study (NCT01930786).
Setting : International clinical sites.
Participants (or Animals, Specimens, Cadavers):
Adult patients with focal spasticity across multiple etiologies.
Interventions : OnabotulinumtoxinA at the clinician’s discretion.
Main Outcome Measure(s) : 15-item Bakas Caregiver Outcomes Scale (BCOS; self-reported at enrollment and 5±1 weeks following patient treatment).
Results:
730 patients (54 years, 52% female, 77% white) received ≥1 dose of onabotulinumtoxinA, and the majority had moderate to severe spasticity at baseline. 37% (n=269) were naive to botulinum toxins for treatment of spasticity. For the treatment-naive patient population, n=122 associated caregivers completed the BCOS at baseline. The majority of caregivers (58 years, 61% female, 72% white) were the spouse or live-in partner of the patient (60%) or were another family member (33%). Approximately half of the caregivers were employed (39% full-time, 11% part-time) and one-third were retired (34%). In comparison with their BCOS score at baseline, caregivers (n=24; post-treatment 2) reported statistically significant improvements (p<0.05) in the categories of time for family activities, level of energy, emotional well-being, time for social activities with friends, and general health following onabotulinumtoxinA treatment for the patient.
Conclusions : In ASPIRE, caregivers of patients treated with onabotulinumtoxinA for spasticity reported less burden. Reduced burden was associated with an increase in caregiver quality of life, as indicated by increased time for family and friends, more energy, and improvements in emotional and general health. ASPIRE provides valuable, real-world data on onabotulinumtoxinA utilization and effectiveness in patients, as well as the impact of treatment on caregiver burden.
