Журнал клинической неврологии и нейрохирургии

Treatment Satisfaction with Botulinum Toxin Type A in Different Neurological Disorders: A Clinic-Based Study

Abstract

Jasem Youssef Al-Hashel, Doaa Youssry Soliman, Ismail Ibrahim Ismail, Samar Farouk Ahmed

Background: The botulinum toxin type A (BoNT-A) is is safe and effective treatment that is used in diverse range of in neurologic  diseases. Patients satisfaction may affect successful treatment outcome.

Objective: To characterize overall patients /caregivers’ satisfaction with BoNT-A treatment for symptom control in different neurologic conditions at clinic.

Methods: A cross-sectional study included all patients of both genders and all age groups who had received at least two BoNT-A treatment sessions in our injection clinic. They were asked to rate overall treatment satisfaction at the peak of treatment effect on a 1 to 10 scale (1=not at all satisfied; 10=fully satisfied). Subjects with a rating of 1–3 were classified as not at all satisfied, those with a rating of 4–7 as somewhat satisfied, and those with a rating of 8–10 as very satisfied.

Results: 548 patients were identified for the studywith mean age 43.66+14.50. Most of participants 389 (71%)were female. At the end of observational period, the mean satisfaction was 7.28 +1.78. Majority of patients52.9%were very satisfied, while 42.2% of patients were somewhat satisfied and 4.9% of patients were not satisfied at all.  There was highly significant difference (p<0.0001) for treatment satisfaction among different neurological disorders. Overall treatment satisfaction with BoNT�?�A was the highest for axillary HH (9.20±0.86) and the least satisfaction was reported in writer’s cramp (4.40±1.67). Overall satisfaction with BoNT�?�A at beak of treatment effect was very satisfaction among patients with axillary HH (100%), palmar HH (94.4%), other neuropathic pain syndromes (85.7%), planter HH (90), trigeminal neuralgia (80). While somewhat overall satisfaction at beak of treatment effect was more reported among patients with cervical dystonia (86.7%), musculoskeletal pain (80) and 77.8% in headache patients. Not at all satisfaction was more recorded among writers cramp patients (40%). There was negative significant correlation between BoNT treatment satisfaction and age of patients, (r =-0.099, P,0.022.  We reported positive significant correlation between BoNT treatment satisfaction and disease duration and treatment adherence (r =0.185, P,0.0001; r =0.242, P=0.001respectively).

Conclusion: Patients satisfaction with BoNT-A therapy for different neurological disorders is overall good. The highest patient’s satisfaction observed with primary focal HH, and the least satisfaction with cervical dystonia and writer’s cramp. Treatment satisfaction improves adherence to treatment.