Ixcellence Network�: an international educational network to improve current practice in the management of cervical dystonia or spastic paresis by botulinum toxin injection

Fheodoroff, Klemens

doi:10.11138/fneur/2017.32.2.103

Cited by 8 publications

(3 citation statements)

References 25 publications

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“…The increase in non-cosmetic applications of BTX is further exemplified by a recent survey of physicians, in which 86% of respondents using BTX to treat cervical dystonia and spastic paresis reported a significant increase in patients treated with BTX injections over the last five years [20]. For professions that treat these two conditions with BTX, Ipsen Biopharm (Wrexham, United Kingdom) created its Ixcellence Network® in 2012 to educate practitioners on best practices and to standardize the treatment methods [21]. This exemplifies that, to expand the medical, non-cosmetic use of botulinum toxin, practicing physicians benefit from training and proper knowledge of indications; adverse effects or contraindications; as well as practice guidelines such as injection intervals and dosages [22].…”

Section: Demand For Structured Training Programs Regarding the Non-co...mentioning

confidence: 99%

Physicians’ Practice of the Non-Cosmetic Uses of Botulinum Toxin: A Cross-Sectional Study in Saudi Arabia

Alzarah¹,

Alabasi²,

Alanazi³

et al. 2022

Cureus

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BackgroundAlthough botulinum toxin (BTX) has mainly been used cosmetically and therapeutically, its field of application is expanding. So far, BTX has shown promising outcomes in the management of a wide variety of medical conditions that are difficult to treat. ObjectivesWe assessed physicians' knowledge and experience regarding the non-cosmetic use of BTX in different clinical settings. MethodsThis is a cross-sectional survey that was conducted in Riyadh, Saudi Arabia, and included physicians from different specialties, with different levels of training, and from different working hospitals. Data were collected by using a self-administered survey to assess physicians' knowledge, experience, current practice, and specific training in relation to Botox administration for non-cosmetic use. ResultsMost participants were residents (76.19%) and specialized in internal medicine (27.62%). The majority worked in governmental hospitals (76.19%). About 73% of our sample were aware of the non-cosmetic indications of BTX, but only 44% and 55% were aware of its contraindications and adverse effects, respectively. Less than one-third (31%) of respondents administered BTX injections in their clinical practice, and about 66% of respondents had two to five years of experience giving BTX injections. The most commonly treated conditions were spastic disorders, dystonia, and then migraine. Only 4.7% and 3.6% used validated scales or instruments for planning treatment with BTX, respectively, while about 36% opted for clinical evaluation only. More experience and training in giving BTX injections significantly predicted increased awareness of adverse effects and contraindications of non-cosmetic uses. ConclusionsThe majority of specialty groups in our sample were aware of the non-cosmetic applications of botulinum toxin but did not use them to the same extent in their practice. Additionally, only a minority wished for further education on injection practices. The finding of insufficient knowledge about contraindications and the adverse effects of injections in a large number of participants, however, highlights the need for increased education, especially given the wide range of non-cosmetic applications and benefits that BTX can have for a variety of diseases.

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Section: Demand For Structured Training Programs Regarding the Non-co...mentioning

confidence: 99%

Physicians’ Practice of the Non-Cosmetic Uses of Botulinum Toxin: A Cross-Sectional Study in Saudi Arabia

Alzarah¹,

Alabasi²,

Alanazi³

et al. 2022

Cureus

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“…For example, different cultures may have different goals for treatment and each country will have their own national approach to care ( 7 ). Moreover, BoNT-A injection practices often depend on the injector training available ( 8 ), and consequently there is significant international variation in the spasticity-assessment tools used as well in muscle selection, dosing and other clinical parameters.…”

Section: Introductionmentioning

confidence: 99%

Botulinum toxin A injection for post-stroke upper limb spasticity and rehabilitation practices from centers across Asian countries

Rosales,

Chia,

Kumthornthip

et al. 2024

Front. Neurol.

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PurposeDescribe real-life practice and outcomes in the management of post-stroke upper limb spasticity with botulinum toxin A (BoNT-A) in Asian settings.MethodsSubgroup analysis of a prospective, observational study (NCT01020500) of adult patients (≥18 years) with post-stroke upper limb spasticity presenting for routine spasticity management, including treatment with BoNT-A. The primary outcome was goal attainment as assessed using goal-attainment scaling (GAS). Patients baseline clinical characteristics and BoNT-A injection parameters are also described.ResultsOverall, 51 patients from Asia were enrolled. Rates of comorbid cognitive and emotional problems were relatively low. Patients tended to have more severe distal limb spasticity and to prioritize active over passive function goals. Most (94.1%) patients in the subgroup were treated with abobotulinumtoxinA. For these patients, the median total dose was 500 units, and the most frequently injected muscles were the biceps brachii (83.3%), flexor carpi radialis (72.9%), and flexor digitorum profundus (66.7%). Overall, 74.5% achieved their primary goal and the mean GAS T score after one treatment cycle was 56.0 ± 13.0, with a change from baseline of 20.9 ± 14.3 (p < 0.001). The majority (96.1%) of Asian patients were rated as having improved.ConclusionIn the Asian treatment setting, BoNT-A demonstrated a clinically significant effect on goal attainment for the real-life management of upper limb spasticity following stroke.

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“…A steering committee of six international experts in SP and CD management developed the Ixcellence Network R , an international educational programme to provide physicians specialized in SP and CD with an opportunity to access best clinical practices and innovations concerning treatment with BoNT-A (19). Ten training centers were selected by the steering committee based on their expertise (five on SP, three on CD and two on pediatric SP).…”

Section: Introductionmentioning

confidence: 99%

Botulinum Neurotoxin-A Injection in Adult Cervical Dystonia and Spastic Paresis: Results From the INPUT (INjection Practice, Usage and Training) Survey

et al. 2020

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Botulinum toxin-A (BoNT-A) is an effective treatment for cervical dystonia (CD) and spastic paresis (SP), but it requires in-depth knowledge of anatomy and injection techniques. The Ixcellence Network ® is an educational programme to provide neurology, neuropaediatrics, and physical medicine and rehabilitation (PMR) specialists with access to best clinical practices and innovations regarding SP and CD management with BoNT-A. To assess the benefits of such educational programmes and identify unmet needs, a multidisciplinary scientific committee designed INPUT (INjection Practice, Usage & Training), an international multicentric survey describing training and practices among this trained and experienced population. A self-completed questionnaire was sent online to 553 trainees and 14 trainers from the Ixcellence Network ®. Among the 131 respondents, 92% specialized in PMR (48%) or neurology (44%), with a mean experience of 15.5 years in their clinical fields and 10.9 years of BoNT-A injection. Most of them (98%) reported having received training before performing their first BoNT-A injection and attending specific courses on how to perform it without any instrumental guidance (76%), and with ultrasound (73%), electrical stimulation (44%) or electromyography (41%). In terms of practices, 92% of respondents reported using at least one guidance technique while injecting, with ultrasound being the most used technique (48%). Attending specific courses was significantly associated with greater self-confidence and use, e.g. for injection with ultrasound, mean self-confidence, on a scale from 1 (not confident) to 10 (fully confident), was 7.9 for trained respondents (vs 4.0 for untrained respondents, p < 0.001) of whom 70% stated that they used this technique regularly or systematically (vs. 11% of untrained healthcare professionals (HCPs), p < 0.0001). Moreover, 84% of respondents reported having trained colleagues, residents or fellows through theoretical (70%) or practical teaching in individuals (80%) or in small groups (65%). Overall, 86% of respondents reported a notable increase over the past Chung et al. Results of the INPUT Survey 5 years of the number of patients treated with BoNT-A. INPUT is the first international survey describing training and practices in SP and CD management of physicians who attended a dedicated educational programme. The results highlighted the importance of training for self-confidence, and the use of specific techniques and new approaches.

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Ixcellence Network�: an international educational network to improve current practice in the management of cervical dystonia or spastic paresis by botulinum toxin injection

Cited by 8 publications

References 25 publications

Physicians’ Practice of the Non-Cosmetic Uses of Botulinum Toxin: A Cross-Sectional Study in Saudi Arabia

Physicians’ Practice of the Non-Cosmetic Uses of Botulinum Toxin: A Cross-Sectional Study in Saudi Arabia

Botulinum toxin A injection for post-stroke upper limb spasticity and rehabilitation practices from centers across Asian countries

Botulinum Neurotoxin-A Injection in Adult Cervical Dystonia and Spastic Paresis: Results From the INPUT (INjection Practice, Usage and Training) Survey

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