Medication, rehabilitation and health care consumption in adults with cerebral palsy: a population based study

• Published in: Clinical rehabilitation 2017-07, Vol.31 (7), p.957-965
• Main Authors: Pons, Christelle, Brochard, Sylvain, Gallien, Philippe, Nicolas, Benoit, Duruflé, Aurélie, Roquet, Marion, Rémy-Néris, Olivier, Garlantezec, Ronan
• Format: Article
• Language: English
• Subjects: Adult; Adults; Antiepileptic drugs; Cerebral palsy; Cerebral Palsy - diagnosis; Cerebral Palsy - drug therapy; Cerebral Palsy - rehabilitation; Classification; Clinical medicine; Consumption; Cross-Sectional Studies; Disability Evaluation; Drugs; Epidemiology; Female; France; Health care; Health Care Costs; Health Services - economics; Health Services - utilization; Humans; Male; Mobility; Motor ability; Orthotic Devices - economics; Orthotic Devices - utilization; Pharmaceutical Preparations - administration & dosage; Physical Therapy Modalities - economics; Physical Therapy Modalities - utilization; Physiotherapy; Population-based studies; Questionnaires; Rehabilitation; Risk Assessment; Surveys and Questionnaires; Wheelchairs; Young Adult
• ISSN: 0269-2155; 1477-0873
• DOI: 10.1177/0269215516663286

Objective: To evaluate medication, rehabilitation and healthcare consumption in adults with CP as a function of Gross Motor Function Classification System (GMFCS) level. Design: Questionnaire-based cross-sectional study. Setting: Brittany, a French county. Subjects: Adults with cerebral palsy. Interventions: Questionnaires relating to drugs, orthotic devices, mobility aids, rehabilitation and medical input were sent to 435 members of a unique regional French network dedicated to adults with cerebral palsy. The questionnaire was completed by the participant or a helper if necessary. Results: Of the 282 responders, 7.8% had a GMFCS level of I, 14.2% II, 17.7% III, 29.1% IV and 31.2% V. Participants consumed a large amount of healthcare. Almost three-quarters took orally administered drugs, of which antispastic and antiepileptic drugs were among the most frequent. Nearly all patients had at least one type of rehabilitation, 87.2% had physiotherapy, 78% used at least one mobility aid and 69.5% used at least one orthotic device. The frequency of numerous inputs increased with GMFCS level. Specificities were found for each GMFCS level, e.g. participants with GMFCS level IV and V had a high level of medical input and a greater use of trunk-supporting devices, antireflux and laxative. Profiles could be established based on GMFCS levels. Conclusions: Adults with cerebral palsy use a large amount of drugs, mobility aids, orthotic devices, rehabilitation and medical input. Healthcare is targeted at cerebral palsy-related issues. GMFCS is a determinant of healthcare consumption and thus a useful tool for clinical practice to target care appropriately.