E Chaléat-Valayer1, M Porte2, K Buchet-Poyau3, F Roumenoff-Turcant4, M C D'Anjou5, C Boulay6, J C Bernard7, S Touzet8. 1. Centre Médico-Chirurgical de Réadaptation des Massues Croix-Rouge française, 69322 Lyon Cedex 05, France. Electronic address: chaleat-valayer.e@cmcr-massues.com. 2. Centre Hospitalier Universitaire de Nîmes, 30029, France. Electronic address: melanie.porte@chu-nimes.fr. 3. Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Lyon F-69003, France. Electronic address: karine.poyau@chu-lyon.fr. 4. Centre Médico-Chirurgical de Réadaptation des Massues Croix-Rouge française, 69322 Lyon Cedex 05, France. Electronic address: f.roumenoff@cmcr-massues.com. 5. Coordination SSR Pédiatrique Hôpital Nord, Saint Etienne 42055, France. Electronic address: m.charlotte.danjou@chu-st-etienne.fr. 6. Service de Neurologie Pédiatrique, CHU Timone Enfants, 13385 Marseille, France. Electronic address: christophe.boulay@ap-hm.fr. 7. Centre Médico-Chirurgical de Réadaptation des Massues Croix-Rouge française, 69322 Lyon Cedex 05, France. Electronic address: bernard-mpr@cmcr-massues.com. 8. Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Lyon F-69003, France; Universite de Lyon, EA 7425 Health Services and Performance Research (HESPER), Lyon F-69008, France. Electronic address: sandrine.touzet@chu-lyon.fr.
Abstract
AIM: To characterise children with cerebral palsy (CP) and pathological drooling in France, and to describe care pathways, assessment and treatment. METHOD: A transversal, observational, descriptive survey of the practices and opinions of 400 health professionals potentially involved in the care of children with CP, was carried out nationally across France in 2013. RESULTS: The response rate was 36%. Seventy-five questionnaires were returned and analysed (52%). A small proportion of children were specifically treated for drooling (<25%). Assessments were carried out in 75% of cases and 91% of professionals prescribed treatments. Use of assessment tools varied widely. The most common treatment was oro-facial rehabilitation (95% of professionals), followed by anticholinergic drugs (Scopolamine(®)) (94%) botulinum toxin injections (BT) (66%) and surgery (34%). Scopolamine was considered to be less effective than BT and to have more side effects. CONCLUSION: The rate of pathological drooling in children with CP is likely underestimated and under treated in France. There is a lack of knowledge regarding assessment tools. Aside from rehabilitation, current practice is to prescribe medication as the first-line treatment, however professionals consider that BT is more effective and has less side effects.
AIM: To characterise children with cerebral palsy (CP) and pathological drooling in France, and to describe care pathways, assessment and treatment. METHOD: A transversal, observational, descriptive survey of the practices and opinions of 400 health professionals potentially involved in the care of children with CP, was carried out nationally across France in 2013. RESULTS: The response rate was 36%. Seventy-five questionnaires were returned and analysed (52%). A small proportion of children were specifically treated for drooling (<25%). Assessments were carried out in 75% of cases and 91% of professionals prescribed treatments. Use of assessment tools varied widely. The most common treatment was oro-facial rehabilitation (95% of professionals), followed by anticholinergic drugs (Scopolamine(®)) (94%) botulinum toxin injections (BT) (66%) and surgery (34%). Scopolamine was considered to be less effective than BT and to have more side effects. CONCLUSION: The rate of pathological drooling in children with CP is likely underestimated and under treated in France. There is a lack of knowledge regarding assessment tools. Aside from rehabilitation, current practice is to prescribe medication as the first-line treatment, however professionals consider that BT is more effective and has less side effects.