We wish to draw attention to the NICE guidelines for spasticity management in children, in particular, recommendations on oral baclofen prescribing.1 Despite its reported efficacy in reducing spastic tone in controlled studies, there is little information on the effectiveness, safety and quality of prescribing of baclofen in real-life practice.2 We noted that non-specialist (paediatric neurology, neurodisability) paediatricians express a lack of experience and knowledge in managing hypertonia with baclofen. The community paediatric setting is where children with hypertonia due to cerebral palsy, the predominant underlying condition, are routinely managed, as opposed to specialist tone management clinics, where controlled studies are typically performed. We conducted a baseline audit in a community paediatric setting of the use of oral baclofen to identify patterns of usage and opportunities for improvement.

The audit was a retrospective case note review in 2010 of children attending Warrington Child …