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Health, wellbeing and lived experiences of adults with SMA: a scoping systematic review

BACKGROUND: Spinal muscular atrophy (SMA) is a neurodegenerative disease that has a substantial and multifaceted burden on affected adults. While advances in supportive care and therapies are rapidly reshaping the therapeutic environment, these efforts have largely centered on pediatric populations....

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Autores principales: Wan, Hamish W. Y., Carey, Kate A., D’Silva, Arlene, Vucic, Steve, Kiernan, Matthew C., Kasparian, Nadine A., Farrar, Michelle A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068910/
https://www.ncbi.nlm.nih.gov/pubmed/32164772
http://dx.doi.org/10.1186/s13023-020-1339-3
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author Wan, Hamish W. Y.
Carey, Kate A.
D’Silva, Arlene
Vucic, Steve
Kiernan, Matthew C.
Kasparian, Nadine A.
Farrar, Michelle A.
author_facet Wan, Hamish W. Y.
Carey, Kate A.
D’Silva, Arlene
Vucic, Steve
Kiernan, Matthew C.
Kasparian, Nadine A.
Farrar, Michelle A.
author_sort Wan, Hamish W. Y.
collection PubMed
description BACKGROUND: Spinal muscular atrophy (SMA) is a neurodegenerative disease that has a substantial and multifaceted burden on affected adults. While advances in supportive care and therapies are rapidly reshaping the therapeutic environment, these efforts have largely centered on pediatric populations. Understanding the natural history, care pathways, and patient-reported outcomes associated with SMA in adulthood is critical to advancing health policy, practice and research across the disease spectrum. The aim of this study was to systematically review research investigating the healthcare, well-being and lived experiences of adults with SMA. METHODS: In accordance with the Preferred Reported Items for Systematic Reviews and Meta-Analysis guidelines, seven electronic databases were systematically searched until January 2020 for studies examining clinical (physical health, natural history, treatment) and patient-reported (symptoms, physical function, mental health, quality of life, lived experiences) outcomes in adults with SMA. Study risk of bias and the level of evidence were assessed using validated tools. RESULTS: Ninety-five articles met eligibility criteria with clinical and methodological diversity observed across studies. A heterogeneous clinical spectrum with variability in natural history was evident in adults, yet slow declines in motor function were reported when observational periods extended beyond 2 years. There remains no high quality evidence of an efficacious drug treatment for adults. Limitations in mobility and daily activities associated with deteriorating physical health were commonly reported, alongside emotional difficulties, fatigue and a perceived lack of societal support, however there was no evidence regarding effective interventions. CONCLUSIONS: This systematic review identifies the many uncertainties regarding best clinical practice, treatment response, and long-term outcomes for adults with SMA. This comprehensive identification of the current gaps in knowledge is essential to guide future clinical research, best practice care, and advance health policy with the ultimate aim of reducing the burden associated with adult SMA.
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spelling pubmed-70689102020-03-18 Health, wellbeing and lived experiences of adults with SMA: a scoping systematic review Wan, Hamish W. Y. Carey, Kate A. D’Silva, Arlene Vucic, Steve Kiernan, Matthew C. Kasparian, Nadine A. Farrar, Michelle A. Orphanet J Rare Dis Review BACKGROUND: Spinal muscular atrophy (SMA) is a neurodegenerative disease that has a substantial and multifaceted burden on affected adults. While advances in supportive care and therapies are rapidly reshaping the therapeutic environment, these efforts have largely centered on pediatric populations. Understanding the natural history, care pathways, and patient-reported outcomes associated with SMA in adulthood is critical to advancing health policy, practice and research across the disease spectrum. The aim of this study was to systematically review research investigating the healthcare, well-being and lived experiences of adults with SMA. METHODS: In accordance with the Preferred Reported Items for Systematic Reviews and Meta-Analysis guidelines, seven electronic databases were systematically searched until January 2020 for studies examining clinical (physical health, natural history, treatment) and patient-reported (symptoms, physical function, mental health, quality of life, lived experiences) outcomes in adults with SMA. Study risk of bias and the level of evidence were assessed using validated tools. RESULTS: Ninety-five articles met eligibility criteria with clinical and methodological diversity observed across studies. A heterogeneous clinical spectrum with variability in natural history was evident in adults, yet slow declines in motor function were reported when observational periods extended beyond 2 years. There remains no high quality evidence of an efficacious drug treatment for adults. Limitations in mobility and daily activities associated with deteriorating physical health were commonly reported, alongside emotional difficulties, fatigue and a perceived lack of societal support, however there was no evidence regarding effective interventions. CONCLUSIONS: This systematic review identifies the many uncertainties regarding best clinical practice, treatment response, and long-term outcomes for adults with SMA. This comprehensive identification of the current gaps in knowledge is essential to guide future clinical research, best practice care, and advance health policy with the ultimate aim of reducing the burden associated with adult SMA. BioMed Central 2020-03-12 /pmc/articles/PMC7068910/ /pubmed/32164772 http://dx.doi.org/10.1186/s13023-020-1339-3 Text en © The Author(s). 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Wan, Hamish W. Y.
Carey, Kate A.
D’Silva, Arlene
Vucic, Steve
Kiernan, Matthew C.
Kasparian, Nadine A.
Farrar, Michelle A.
Health, wellbeing and lived experiences of adults with SMA: a scoping systematic review
title Health, wellbeing and lived experiences of adults with SMA: a scoping systematic review
title_full Health, wellbeing and lived experiences of adults with SMA: a scoping systematic review
title_fullStr Health, wellbeing and lived experiences of adults with SMA: a scoping systematic review
title_full_unstemmed Health, wellbeing and lived experiences of adults with SMA: a scoping systematic review
title_short Health, wellbeing and lived experiences of adults with SMA: a scoping systematic review
title_sort health, wellbeing and lived experiences of adults with sma: a scoping systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068910/
https://www.ncbi.nlm.nih.gov/pubmed/32164772
http://dx.doi.org/10.1186/s13023-020-1339-3
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