Botulinum Toxin Type A Satisfaction in Different Neurological Disorders

Background: The botulinum toxin type A (BoNT-A) is used in a wide range of neurological diseases. We aimed to study the overall patients/caregivers’ satisfaction with BoNT-A treatment in different neurological conditions. Methods: Prospective study included patients who had received at least two BoNT-A treatment sessions. 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 1to3 were classified as not at all satisfied, those with a rating of 4 to7 as somewhat satisfied, and those with a rating of 8 to10 as very satisfied. Treatment satisfaction questionnaire for medicine (TSQM) was assessed at the end of observational period. Quality of life QOL was assessed before BoNT-A treatment and at the last visit. Results: The study was conducted from first April 2014 to August 2021. 548 patients were identified with 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. There was a highly significant difference (P < 0.0001) for treatment satisfaction among different neurological disorders. Total TSQM with BoNT-A was the highest for axillary hyperhidrosis (HH) (90.45 ± 0.62), followed by chronic migraine (72.13 ± 1.59) and the least TSQM was reported in writer’s cramp (40.44 ± 1.57). Overall satisfaction with BoNT-A at the peak of treatment effect among patients with axillary HH (100%), palmar HH (94.4%), neuropathic pain syndromes (85.7%), planter HH (90%), trigeminal neuralgia (80%). While patients with cervical dystonia (86.7%) and musculoskeletal pain (80%) patients were somewhat satisfied. Not at all satisfied rates were recorded among writer’s cramp patients (40%). Total TSQM with BoNT-A was highest for axillary HH 90.45 ± 0.62 and least satisfaction was reported in writer’s cramp 40.44 ± 1.57. QOL significantly improved at the end of observational period (71.93 versus 104.52; P < 0.0001).We reported a positive significant correlation between BoNT-A treatment satisfaction and treatment adherence (r = 0.242, P = 0.001). Conclusion: Satisfaction with BoNT-A therapy for different neurological disorders is overall good. The highest patient satisfaction was observed with primary focal HH, and the least satisfaction was observed in writer’s cramp. BoNT-A therapy improved QOL.