Optimizing Care With a Standardized Management Protocol for Patients With Infantile Spasms.

Abstract

The primary aim of this quality improvement initiative was to increase the number of patients receiving first-line therapy (adrenocorticotropic hormone, corticosteroids, vigabatrin) as the initial treatment for infantile spasms. We implemented a standardized management protocol for infantile spasms based on the best available data and expert consensus. To assess the impact of this intervention, we compared the 3-month remission rates between prestandardization (January 2009 to August 2012) and poststandardization (September 2012 to May 2014) cohorts. We found that the percentage of patients receiving first-line therapy as the initial treatment was 57% (31/54) in the prestandardization cohort and 100% (35/35) in the poststandardization cohort (P < .001). The rate of infantile spasms remission was higher poststandardization compared to prestandardization (78.8% vs 30.6%, P < .001). Management standardization led to all patients receiving first-line therapy as the initial treatment and was associated with a significantly improved rate of infantile spasms remission 3 months after diagnosis.

• Authors: Erin M Fedak, Anup D Patel, Geoffrey L Heyer, Eric G Wood, John R Mytinger
• Journal: Journal of child neurology (J Child Neurol) Vol. 30 Issue 10 Pg. 1340-2 (Sep 2015) ISSN: 1708-8283 [Electronic] United States
• PMID: 25535057 (Publication Type: Journal Article)
• Copyright: © The Author(s) 2014.

Chemical References

• Anticonvulsants

Topics

• Anticonvulsants (therapeutic use)
• Disease Management
• Humans
• Infant
• Length of Stay
• Practice Guidelines as Topic
• Remission Induction
• Retrospective Studies
• Spasms, Infantile (therapy)
• Treatment Outcome