Neuropediatrics 2020; 51(06): 377-388
DOI: 10.1055/s-0040-1716901
Review Article

Improving Management of Infantile Spasms by Adopting Implementation Science

Debopam Samanta
1  Child Neurology Section, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
› Author Affiliations
Funding Dr. Samanta reports grants from the Translational Research Institute and the National Center for Advancing Translational Sciences of the National Institutes of Health (grant UL1 TR003107 ) during the conduct of the study.

Abstract

Over the last several decades, significant progress has been made in the discovery of appropriate therapy in the management of infantile spasms (IS). Based on several well-controlled studies, the American Academy of Neurology and the Child Neurology Society have published the current best practice parameters for the treatment of IS. However, dissemination and implementation of evidence-based guidelines remain a significant challenge. Though the number of well-performed controlled trials and systematic reviews is increasing exponentially, the proportion of valuable new information subsequently embedding into the routine clinical care is significantly lower. Planned and systematic implementation of evidence-based interventions in a given health care structure may outstrip the benefits of discovering a new insight, procedure, or drug in another controlled setting. Implementation problems can be broad-ranging to hinder effective, efficient, safe, timely, and patient-centered care without significant variation. The first part of this review article provides a detailed summary of some crucial comparative treatment studies of IS available in the literature. In the second part, practical challenges to mitigate the gap between knowledge and practice to improve outcomes in the management of IS has been explored, and a consolidated framework approach for systematic implementation research methodology has been discussed to implement evidence-based guidelines for the management of IS. Although large multicenter controlled studies will help gather quality evidence in the treatment of IS, a more comprehensive range of scientific methodologies, including qualitative research and mixed research methodologies, will hold the more considerable promise for implementing evidence-based practices in the health care system.

Disclosures

The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.




Publication History

Received: 26 March 2020

Accepted: 31 July 2020

Publication Date:
13 October 2020 (online)

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