Patient satisfaction with botulinum toxin therapy in adult spasticity

Aims: Health-care authorities in the UK are legally required to consult patients and public on optimizing service delivery. Yet to the authors' knowledge, only one audit of patient satisfaction with botulinum toxin (BTX) treatment of spasticity have been published, and no surveys have been conducted in this area. This survey aimed to gain insights into patient perceptions of performance of one service delivering BTX therapy for patients with spasticity in one UK setting, to improve service delivery. Methods: A questionnaire to explore patient satisfaction was developed and piloted by the authors, and sent to a convenience sample of 100 patients seen by the service. Findings: Questionnaire findings suggest that centralized vs peripatetic services, patient and treatment team characteristics, patients' expectations and the treatment setting are influential factors in patient satisfaction. The majority of patients felt that the service met their expectations. Patient dissatisfaction centred on lengthy waiting times. Conclusions: Patient satisfaction is an essential part of the evidence base necessary to evaluate or change a clinical service. This survey revealed dissatisfaction with waiting times for BTX therapy; finding a new therapeutic role for physiotherapists as physio-injectors-rather than BTX injections being provided solely by consultants-is suggested as a potential solution to this. Advantages and disadvantages of potential implications of this are assessed. There is a need for a validated questionnaire and carefully refined multidisciplinary research to build on these service evaluation findings.