Objective:
To determine the reasons for discontinuation of Botulinum Toxin Type A injections for spasmodic dysphonia (SD), at our institution.
Study Design:
Retrospective chart review of 431 patients treated with Botulinum Toxin Type A injections for SD at Loyola University Medical Center between May 1989 and June 1997. Mailed survey to those who had not appeared for treatment in the year preceding June 1997.
Methods:
Charts of the entire patient caseload (431 patients) were reviewed to find patients who had not appeared for treatment for more than one year. A survey was mailed to ask patients their reasons for not returning. Answers were tabulated.
Results:
Two-thirds of patients who had discontinued treatment at our facility had been satisfied with treatment at Loyola University -- Chicago. Most of these were receiving Botulinum Toxin Type A injections closer to home. Of those dissatisfied with treatment, most common mention was made of excessive initial side effects, logistical inconvenience related to distance, and poor insurance coverage.
Conclusions:
Patients with spasmodic dysphonia typically experience dramatic relief of symptoms via periodic vocal fold injections of Botulinum Toxin Type A. Some patients, however, drop out of treatment. Starting treatment with a very low initial dosage, improving local availability, and lowering cost and/or enhancing insurance coverage may improve patient satisfaction and decrease treatment dropout rates.
KEY WORDS:
SPASMODIC DYSPHONIA, SURVEY, PATIENT SATISFACTION, BOTOX, BOTULINUM TOXIN TYPE A, DYSTONIA
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