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Frequency and determinants of using pharmacological enhancement in the clinical practice of in-hospital stroke rehabilitation.

Abstract

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.

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  • Publisher Full Text

    • Authors

    Engelter ST, Urscheler N, Baronti F, Vuadens P, Koch J, Frank M, Disserens K, Jenni W

    Institution

    Neurorehabilitation Unit, Geriatric Competence Center, Felix Platter-Spital, Basel, Switzerland. stefan.engelter@fps-basel.ch

    Source

    European neurology 68:1 2012 pg 28-33

    MeSH

    Aged
    Female
    Humans
    Male
    Physician's Practice Patterns
    Recovery of Function
    Stroke

    Pub Type(s)

    Journal Article
    Multicenter Study

    Language

    eng

    PubMed ID

    22677938