Physical Therapy Products Editor Melanie Hamilton-Basich recently interviewed Anand Patel, Global Pipeline Therapeutic Neurotoxin Lead at AbbVie, about the company’s new PSS Referral Tool that uses red, green, and yellow classification levels to help healthcare professionals prioritize patients at risk for post-stroke spasticity (PSS). 

Can you briefly describe your background, and how you were involved in the development of AbbVie’s PSS Referral Tool?

I am a urologist by training and obtained my medical degree from Leeds, UK, and became a member of the Royal College of Surgeons. I have been working with botulinum toxins for nearly 20 years and have held positions in clinical development and medical affairs. 

I have been involved in the development of AbbVie’s app used to prioritize patients at risk for post-stroke spasticity as part of my role leading the Medical Affairs Pipeline Therapeutic Neurotoxin Team at AbbVie, where I collaborate on various pipeline indications to take forward innovative advancements in patient care. Our team at AbbVie is dedicated to improving patient outcomes and developing innovative solutions for healthcare professionals. The PSS Referral Tool was created to provide a reliable, easy to use, and efficient method for identifying and referring patients at risk of PSS, ultimately enhancing the rehabilitation process and improving the quality of life for stroke survivors.

Anand Patel, Global Pipeline Therapeutic Neurotoxin Lead at AbbVie
Anand Patel, Global Pipeline Therapeutic Neurotoxin Lead at AbbVie. Photo: AbbVie

Why did you feel AbbVie’s PSS Referral Tool needed to be developed? What need does it fill for physical therapists treating people recovering from a stroke?

AbbVie recognized the need for a scientifically driven, reliable, and efficient method to identify and refer patients at risk of PSS. This condition can significantly impact a patient’s quality of life and functional ability after a stroke. However, many healthcare professionals are not aware of the signs that would suggest that a patient with post-stroke spasticity needs referral and may benefit from more focused treatment; therefore, many patients continue to struggle with the functional and quality of life limitations when there is potential to improve their spasticity. 

The AbbVie PSS Referral Tool was developed to address this need and provide healthcare professionals with an effective and highly sensitive tool to identify symptoms and signs of PSS. By using this tool, physical therapists enhance the rehabilitation and referral process and hopefully more patients will experience an improved quality of life and functional outcomes.

How does the AbbVie “traffic light” classification tool work in practice, and who is it intended for?

The AbbVie PSS Referral Tool utilizes a “traffic light” classification system to help healthcare professionals identify patients at risk of PSS. This tool is intended for use by a wide range of healthcare professionals, including occupational therapists, rehabilitation therapists, physical therapists, neurologists, and more. It was developed so that healthcare professionals who are not specialists in spasticity management can easily utilize the tool. 

The tool works by assessing various symptoms and signs associated with PSS and categorizing patients into three risk levels: green (low risk), yellow (moderate risk), and red (high risk). This classification system allows rehab professionals to prioritize those patients who may need interventions so that they can be promptly referred to an appropriate specialist.

Can you tell us about the new study looking at the effectiveness of the AbbVie tool, and why you feel the findings are so promising?

The PSS Referral Tool Validity Study involved 50 clinicians from 13 countries who viewed videos of patients virtually. Each patient in the videos was previously classified by a panel of experts as either ‘red,’ ‘yellow,’ or ‘green’ based on the classification in the PSS referral tool. The aim of the study was to see if other healthcare professionals who may use the PSS referral tool would classify the patients the same as the experts. This approach measures the ‘interrater reliability’ of the PSS referral tool. 

This approach ensured that we could assess the interrater reliability in a diverse group of HCPs from across the globe. The study’s findings demonstrated a sensitivity level of 93.3% among healthcare professionals with no prior experience using the tool. In particular, it showed that patients requiring urgent referral were rarely misclassified (inter-rater reliability of 69%), highlighting the tool’s effectiveness in ensuring that appropriate patients are referred for specialist assessment. The study’s results validate the reliability of the AbbVie PSS Referral Tool, providing physical therapists with a valuable resource to improve patient care.

Where can interested rehab professionals find the PSS Referral Tool?

The PSS Referral tool is available in the PSS (Post Stroke Spasticity): Early Identification (ID) app. Interested physical therapists can find the app on their smartphones (via Apple or Google). Within the app, healthcare professionals can classify cases and earn points by using the tool to identify and refer patients at risk of PSS. The app also provides additional resources for learning more about PSS.