The barriers and facilitators to satisfaction with botulinum neurotoxin treatment in people with cervical dystonia: a systematic review.

Boyce, MJ; McCambridge, AB; Bradnam, LV; Canning, CG; Verhagen, AP

The barriers and facilitators to satisfaction with botulinum neurotoxin treatment in people with cervical dystonia: a systematic review.

Boyce, MJ McCambridge, AB Bradnam, LV Canning, CG Verhagen, AP

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Publisher:: Springer
Publication Type:: Journal Article
Citation:: Neurological Sciences, 2022, 43, (8), pp. 4663-4670
Issue Date:: 2022-08

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Field	Value	Language
dc.contributor.author	Boyce, MJ
dc.contributor.author	McCambridge, AB
dc.contributor.author	Bradnam, LV
dc.contributor.author	Canning, CG
dc.contributor.author	Verhagen, AP
dc.date.accessioned	2022-11-30T04:31:34Z
dc.date.available	2022-04-30
dc.date.available	2022-11-30T04:31:34Z
dc.date.issued	2022-08
dc.identifier.citation	Neurological Sciences, 2022, 43, (8), pp. 4663-4670
dc.identifier.issn	1590-1874
dc.identifier.issn	1590-3478
dc.identifier.uri	http://hdl.handle.net/10453/163923
dc.description.abstract	BACKGROUND: Cervical dystonia (CD) is an isolated, focal, idiopathic dystonia affecting the neck and upper back. CD is usually treated by botulinum neurotoxin (BoNT) injections into the dystonic muscles; however, about 20% of people will discontinue BoNT therapy. This systematic review aimed to determine the barriers to satisfaction and facilitators that could improve satisfaction with BoNT therapy for people with CD. METHODS: A database search for journal articles investigating satisfaction with BoNT treatment in CD identified seven qualitative studies and one randomised controlled trial. Results were grouped into "direct" and "indirect" barriers and facilitators. RESULTS: The most reported direct barrier to satisfaction with BoNT was treatment non-response, reported by up to 66% of participants. Other direct barriers included negative side effects, early wearing-off of treatment effect and inexperience of the treating physician. Indirect barriers included limited accessibility to treatment (including cost) and personal choice. Direct facilitators of satisfaction with BoNT included relief of symptoms and flexible re-treatment intervals. Indirect facilitators included easy accessibility to treatment. CONCLUSIONS: Despite BoNT having a discontinuation rate of only 20%, it appears a much greater proportion of people with CD are dissatisfied with this treatment. As BoNT is currently the main treatment offered to people with CD, efforts to improve treatment response rates, reduce side effects and make treatment more flexible and readily available should be adopted to improve the quality of life for people with CD.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Springer
dc.relation.ispartof	Neurological Sciences
dc.relation.isbasedon	10.1007/s10072-022-06114-8
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1103 Clinical Sciences, 1109 Neurosciences
dc.subject.classification	Neurology & Neurosurgery
dc.subject.mesh	Botulinum Toxins
dc.subject.mesh	Botulinum Toxins, Type A
dc.subject.mesh	Dystonic Disorders
dc.subject.mesh	Humans
dc.subject.mesh	Neuromuscular Agents
dc.subject.mesh	Personal Satisfaction
dc.subject.mesh	Quality of Life
dc.subject.mesh	Randomized Controlled Trials as Topic
dc.subject.mesh	Torticollis
dc.subject.mesh	Botulinum Toxins
dc.subject.mesh	Botulinum Toxins, Type A
dc.subject.mesh	Dystonic Disorders
dc.subject.mesh	Humans
dc.subject.mesh	Neuromuscular Agents
dc.subject.mesh	Personal Satisfaction
dc.subject.mesh	Quality of Life
dc.subject.mesh	Randomized Controlled Trials as Topic
dc.subject.mesh	Torticollis
dc.subject.mesh	Humans
dc.subject.mesh	Dystonic Disorders
dc.subject.mesh	Torticollis
dc.subject.mesh	Neuromuscular Agents
dc.subject.mesh	Botulinum Toxins
dc.subject.mesh	Personal Satisfaction
dc.subject.mesh	Quality of Life
dc.subject.mesh	Randomized Controlled Trials as Topic
dc.subject.mesh	Botulinum Toxins, Type A
dc.title	The barriers and facilitators to satisfaction with botulinum neurotoxin treatment in people with cervical dystonia: a systematic review.
dc.type	Journal Article
utslib.citation.volume	43
utslib.location.activity	Italy
utslib.for	1103 Clinical Sciences
utslib.for	1109 Neurosciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Graduate School of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Graduate School of Health/GSH.Physiotherapy
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2022-11-30T04:31:30Z
pubs.issue	8
pubs.publication-status	Published
pubs.volume	43
utslib.citation.issue	8

Abstract:

BACKGROUND: Cervical dystonia (CD) is an isolated, focal, idiopathic dystonia affecting the neck and upper back. CD is usually treated by botulinum neurotoxin (BoNT) injections into the dystonic muscles; however, about 20% of people will discontinue BoNT therapy. This systematic review aimed to determine the barriers to satisfaction and facilitators that could improve satisfaction with BoNT therapy for people with CD. METHODS: A database search for journal articles investigating satisfaction with BoNT treatment in CD identified seven qualitative studies and one randomised controlled trial. Results were grouped into "direct" and "indirect" barriers and facilitators. RESULTS: The most reported direct barrier to satisfaction with BoNT was treatment non-response, reported by up to 66% of participants. Other direct barriers included negative side effects, early wearing-off of treatment effect and inexperience of the treating physician. Indirect barriers included limited accessibility to treatment (including cost) and personal choice. Direct facilitators of satisfaction with BoNT included relief of symptoms and flexible re-treatment intervals. Indirect facilitators included easy accessibility to treatment. CONCLUSIONS: Despite BoNT having a discontinuation rate of only 20%, it appears a much greater proportion of people with CD are dissatisfied with this treatment. As BoNT is currently the main treatment offered to people with CD, efforts to improve treatment response rates, reduce side effects and make treatment more flexible and readily available should be adopted to improve the quality of life for people with CD.

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http://hdl.handle.net/10453/163923