Real-world use of botulinum toxin-A for post-stroke spasticity in the Netherlands: a retrospective claims study.
Abstract
[OBJECTIVE] The aim of this observational study was to describe the real-world use of botulinum toxin-A in patients with a stroke in the Netherlands.
[METHODS] This study used longitudinal insurance claims data between 2012 and 2016 with 30% nationwide coverage and included patients with both stroke-related and botulinum toxin-A claims. All analyses were descriptive and displayed as summary statistics.
[RESULTS] 60,222 patients with a stroke were identified, of whom 18,141 (30.1%) were treated in a rehabilitation centre or hospital and 1.7% (1,036 patients) were treated with botulinum toxin-A. A total of 2,855 botulinum toxin-A claims from 890 patients were included in the analysis (1.5% of all patients in the database). Mean age was 63.4 (SD ± 14.0) years at index injection cycle, with a median follow-up of 3.7 years (interquartile range [IQR] 2.2-4.5 years). Patients received up to 16 injection cycles with a median of 2 injection cycles (IQR 1-5 cycles). The median Time-To-Next-Injection-Cycle was 17 weeks (IQR 13-25 weeks). The total number of injection cycles was 604 for abobotulinumtoxinA (22.1%) and 2,251 (78.8%) for onabotulinumtoxinA. Doses per cycle ranged from 200-660 for abobotulinumtoxinA and 101-400 units for onabotulinumtoxinA.
[DISCUSSION] Claims data from a national healthcare insurance fund in the Netherlands showed that only 1.7% of patients with post-stroke spasticity received botulinum toxin-A. Botulinum toxin-A treatment doses and intervals varied widely across patients and most patients received only 1 or 2 botulinum toxin-A injection cycles. Our results suggest undertreatment of spasticity with botulinum toxin-A and suboptimal treatment adherence in Dutch clinical practice.
[METHODS] This study used longitudinal insurance claims data between 2012 and 2016 with 30% nationwide coverage and included patients with both stroke-related and botulinum toxin-A claims. All analyses were descriptive and displayed as summary statistics.
[RESULTS] 60,222 patients with a stroke were identified, of whom 18,141 (30.1%) were treated in a rehabilitation centre or hospital and 1.7% (1,036 patients) were treated with botulinum toxin-A. A total of 2,855 botulinum toxin-A claims from 890 patients were included in the analysis (1.5% of all patients in the database). Mean age was 63.4 (SD ± 14.0) years at index injection cycle, with a median follow-up of 3.7 years (interquartile range [IQR] 2.2-4.5 years). Patients received up to 16 injection cycles with a median of 2 injection cycles (IQR 1-5 cycles). The median Time-To-Next-Injection-Cycle was 17 weeks (IQR 13-25 weeks). The total number of injection cycles was 604 for abobotulinumtoxinA (22.1%) and 2,251 (78.8%) for onabotulinumtoxinA. Doses per cycle ranged from 200-660 for abobotulinumtoxinA and 101-400 units for onabotulinumtoxinA.
[DISCUSSION] Claims data from a national healthcare insurance fund in the Netherlands showed that only 1.7% of patients with post-stroke spasticity received botulinum toxin-A. Botulinum toxin-A treatment doses and intervals varied widely across patients and most patients received only 1 or 2 botulinum toxin-A injection cycles. Our results suggest undertreatment of spasticity with botulinum toxin-A and suboptimal treatment adherence in Dutch clinical practice.
추출된 의학 개체 (NER)
| 유형 | 영어 표현 | 한국어 / 풀이 | UMLS CUI | 출처 | 등장 |
|---|---|---|---|---|---|
| 시술 | botulinum toxin
|
보툴리눔독소 주사 | dict | 9 | |
| 약물 | [OBJECTIVE]
|
scispacy | 1 | ||
| 약물 | [RESULTS] 60,222 patients
|
scispacy | 1 | ||
| 약물 | abobotulinumtoxinA
|
scispacy | 1 | ||
| 약물 | Doses
|
scispacy | 1 | ||
| 질환 | post-stroke spasticity
|
scispacy | 1 | ||
| 질환 | stroke
|
C0038454
Cerebrovascular accident
|
scispacy | 1 | |
| 질환 | stroke-related
|
scispacy | 1 | ||
| 질환 | spasticity
|
C0026838
Muscle Spasticity
|
scispacy | 1 | |
| 기타 | botulinum toxin-A
|
scispacy | 1 | ||
| 기타 | patients
|
scispacy | 1 | ||
| 기타 | botulinum toxin-A. A
|
scispacy | 1 |
MeSH Terms
Humans; Botulinum Toxins, Type A; Muscle Spasticity; Netherlands; Male; Female; Middle Aged; Retrospective Studies; Stroke; Aged; Neuromuscular Agents; Stroke Rehabilitation
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