Barriers to the use of Methylphenidate in Pediatric Neuro-oncology Services.

IF 1.3 4区 医学 Q4 BEHAVIORAL SCIENCES
Alexander J Hagan, Simon Bailey, Sarah J Verity
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引用次数: 0

Abstract

Background: Survivors of childhood CNS tumors are at a significant risk of chronic and multifaceted neurocognitive late effects. Recent findings indicate the potential utility of methylphenidate in addressing neurocognitive and academic plateauing and improving quality-of-life outcomes in this clinical population. However, the prescription of methylphenidate in neuro-oncology services remains inconsistent.

Objective: To explore the neurocognitive assessment and rehabilitative interventions (including the use of methylphenidate) offered to survivors of childhood CNS tumors within mainland UK.

Method: We used a semi-structured questionnaire to gather qualitative data from clinical psychologists and neuropsychologists within National Health Service pediatric neuro-oncology principal treatment centers (PTCs) during May 2018. Thematic analytical methods were used to explore themes within the collected data.

Results: Eleven (58%) of the 19 PTCs returned the completed questionnaire. Respondents reported inadequate resource of psychology in many pediatric neuro-oncology PTCs, which limited the provision of methylphenidate to a restricted proportion of the patient group (i.e., those with the most profound neurocognitive difficulties). Respondents reported an interest in exploring the utility of methylphenidate in their patient group yet described a lack of appropriate evidence of its efficacy. In addition, respondents highlighted the need for the provision of accessible research summaries and treatment protocols addressing the use of methylphenidate.

Conclusion: We anticipate that national collaboration between clinicians and researchers working in the cancer survivorship field will support the advancement of interventions such as methylphenidate for the growing clinical population of survivors of childhood CNS tumors.

儿童神经肿瘤服务中使用哌甲酯的障碍。
背景:儿童中枢神经系统肿瘤的幸存者具有慢性和多方面神经认知晚期影响的显著风险。最近的研究结果表明,哌甲酯在解决该临床人群的神经认知和学术停滞以及改善生活质量方面具有潜在的效用。然而,神经肿瘤服务中哌甲酯的处方仍然不一致。目的:探讨英国大陆儿童中枢神经系统肿瘤幸存者的神经认知评估和康复干预措施(包括哌甲酯的使用)(PTC)。专题分析方法用于探讨收集数据中的专题。结果:19例PTC中有11例(58%)返回了完整的问卷。受访者报告称,在许多儿科神经肿瘤学PTC中,心理学资源不足,这将哌甲酯的提供限制在患者组的有限比例(即那些有最严重神经认知困难的患者)。受访者表示有兴趣探索哌甲酯在其患者群体中的效用,但缺乏适当的疗效证据。此外,答复者强调,有必要提供可查阅的研究摘要和治疗方案,以解决哌甲酯的使用问题。结论:我们预计,从事癌症生存领域工作的临床医生和研究人员之间的国家合作将支持哌甲酯等干预措施的发展,以应对儿童中枢神经系统肿瘤幸存者的临床增长。
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来源期刊
CiteScore
2.40
自引率
7.10%
发文量
68
审稿时长
>12 weeks
期刊介绍: Cognitive and Behavioral Neurology (CBN) is a forum for advances in the neurologic understanding and possible treatment of human disorders that affect thinking, learning, memory, communication, and behavior. As an incubator for innovations in these fields, CBN helps transform theory into practice. The journal serves clinical research, patient care, education, and professional advancement. The journal welcomes contributions from neurology, cognitive neuroscience, neuropsychology, neuropsychiatry, and other relevant fields. The editors particularly encourage review articles (including reviews of clinical practice), experimental and observational case reports, instructional articles for interested students and professionals in other fields, and innovative articles that do not fit neatly into any category. Also welcome are therapeutic trials and other experimental and observational studies, brief reports, first-person accounts of neurologic experiences, position papers, hypotheses, opinion papers, commentaries, historical perspectives, and book reviews.
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