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Journals / SDÜ Tıp Fakültesi Dergisi / 2026 / Cilt: 33 Sayı: 3

BoNT-A Treatment Continuity and Patient- or Caregiver-Reported Reasons for Discontinuation or Irregular Continuation in Post-Stroke Spasticity: A Retrospective Cohort Study

Halenur Yaman(SÜLEYMAN DEMİREL ÜNİVERSİTESİ, TIP FAKÜLTESİ)0009-0007-8738-6071
Serpil Savaş(SÜLEYMAN DEMİREL ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, FİZİK TEDAVİ VE REHABİLİTASYON ANABİLİM DALI)0000-0003-4601-534X
Pages
267–277
Publication Date
2026-09-24
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

These findings suggest that clearer and standardized patient/caregiver education, together with regular follow- up systems, may support treatment continuity in BoNT-A therapy.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective This study aimed to evaluate botulinum neurotoxin type A (BoNT-A) treatment continuity in patients with post-stroke spasticity, to identify patient- or caregiver- reported reasons for treatment discontinuation or irregular continuation, and to examine the associations between available demographic/clinical variables and the number of injections.
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Key Findings & Data:Material and Methods In this retrospective cohort study, medical records of patients who received at least one botulinum toxin injection for post-stroke spasticity between 2012 and 2024 were reviewed.
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Conclusion & Impact:These findings suggest that clearer and standardized patient/caregiver education, together with regular follow- up systems, may support treatment continuity in BoNT-A therapy.
🔬Design:Review & Systematic Survey
📍Scope:2012 Verileri
⚙️Variables:Botulinum toxin type A · Post-stroke spasticity · Treatment adherence

Abstract

Objective This study aimed to evaluate botulinum neurotoxin type A (BoNT-A) treatment continuity in patients with post-stroke spasticity, to identify patient- or caregiver- reported reasons for treatment discontinuation or irregular continuation, and to examine the associations between available demographic/clinical variables and the number of injections. Material and Methods In this retrospective cohort study, medical records of patients who received at least one botulinum toxin injection for post-stroke spasticity between 2012 and 2024 were reviewed. A total of 81 patients included in the final analysis responded to questions regarding reasons for not maintaining regular BoNT-A treatment. Results A total of 157 injections were administered over the 12-year study period. The mean number of injections was 1.9 (range: 1–7), and the mean interval between consecutive injections was 13.3 months. Forty-seven patients (58%) received only one injection session. Reasons for treatment discontinuation or irregular continuation were analyzed among 74 patients after excluding 7 patients who continued treatment at another center. The most frequently reported reason was lack of awareness regarding the need for repeated BoNT-A injections (54.1%). Other reasons included perceived lack of benefit from the injection (24.3%), reduction in spasticity (10.8%), comorbidities or other health problems limiting follow-up (6.8%), fear of injections (4.1%), inability to take time off work (1.4%), and misconception regarding reimbursement coverage (1.4%). Conclusion BoNT-A treatment continuity was low among patients with post-stroke spasticity. The most frequently reported reason for treatment discontinuation or irregular continuation was patient- or caregiver-reported lack of awareness regarding the need for repeated treatment. These findings suggest that clearer and standardized patient/caregiver education, together with regular follow- up systems, may support treatment continuity in BoNT-A therapy.

Özet

Objective This study aimed to evaluate botulinum neurotoxin type A (BoNT-A) treatment continuity in patients with post-stroke spasticity, to identify patient- or caregiver- reported reasons for treatment discontinuation or irregular continuation, and to examine the associations between available demographic/clinical variables and the number of injections. Material and Methods In this retrospective cohort study, medical records of patients who received at least one botulinum toxin injection for post-stroke spasticity between 2012 and 2024 were reviewed. A total of 81 patients included in the final analysis responded to questions regarding reasons for not maintaining regular BoNT-A treatment. Results A total of 157 injections were administered over the 12-year study period. The mean number of injections was 1.9 (range: 1–7), and the mean interval between consecutive injections was 13.3 months. Forty-seven patients (58%) received only one injection session. Reasons for treatment discontinuation or irregular continuation were analyzed among 74 patients after excluding 7 patients who continued treatment at another center. The most frequently reported reason was lack of awareness regarding the need for repeated BoNT-A injections (54.1%). Other reasons included perceived lack of benefit from the injection (24.3%), reduction in spasticity (10.8%), comorbidities or other health problems limiting follow-up (6.8%), fear of injections (4.1%), inability to take time off work (1.4%), and misconception regarding reimbursement coverage (1.4%). Conclusion BoNT-A treatment continuity was low among patients with post-stroke spasticity. The most frequently reported reason for treatment discontinuation or irregular continuation was patient- or caregiver-reported lack of awareness regarding the need for repeated treatment. These findings suggest that clearer and standardized patient/caregiver education, together with regular follow- up systems, may support treatment continuity in BoNT-A therapy.

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Cite This Article

Yaman, H., Savaş, S. (2026). BoNT-A Treatment Continuity and Patient- or Caregiver-Reported Reasons for Discontinuation or Irregular Continuation in Post-Stroke Spasticity: A Retrospective Cohort Study. SDÜ Tıp Fakültesi Dergisi, Cilt: 33 Sayı: 3, 267–277. https://doi.org/10.17343/sdutfd.1893598

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