G520(P) Measuring efficacy of a new service: botulinum toxin for children with spasticity. (May 2019) - Cockburn, CS
Abstract : Introduction: A Paediatric Botulinum Toxin Clinic was set up as a new clinical service in a district general in March 2016 for children with focal spasticity. Botulinum toxin is used in children to improve their skills and ease management for carers. Children are assessed before and after the procedure to measure outcomes of treatment. Aims: To assess the efficacy of the new Botulinum Toxin Clinic over the first two years of service. The primary aim was to assess the effectiveness of the treatment provided. A Goal Attainment Scale (GAS) was used to set individual therapeutic goals for each child. The GAS goals were used as a measure of effectiveness. Methods: Data was collected using the pro-forma completed at the assessment clinic. Data was collected on demographics, diagnosis, gross motor function classification system level (GMFCS), sedation and outcome. The data was collected over two time frames: year 1 from March 2016 to February 2017 and year 2 March 2017 to February 2018. Results: Fifty children were treated with botulinum toxin during the first year from March 2016 to February 2017 and of these, 62% of patients attained their set GAS goals. Thirty six children were treated during the second year. GAS goals were set in 29 of these patients (81%). Sixty two percent attained their GAS goals (18/29). Of those, 72% attained all their individually set therapeutic goals and 22% achieved some of their goals. Fifty six percent exceeded at least one of their GAS goals. Of those who didn't achieve their GAS goals almost 40% did show some improvement in their function. Conclusions: In total over the past two years, 86 children have been treated with botulinum toxin in the local district general hospital instead of traveling to a tertiary centre. By setting GAS goals for the individual young person it allowed effectiveness of the treatment to be assessed. Over both years 62% of children have met their GAS goals after treatment. In addition, when goals were not met there was an improvement in 40%. This data suggests that the local botulinum toxin clinic is providing an effective service.