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P65 Implementing a pain scale to improve botulinum toxin practice for cervical dystonia
  1. Aaron Jesuthasan1,
  2. Amit Batla2,
  3. Kailash Bhatia2
  1. 1Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne
  2. 2The National Hospital for Neurology and Neurosurgery, London, UK


Objectives To evaluate the effectiveness of introducing a pain scale to improve cervical dystonia (CD) patient satisfaction rates in the National Hospital for Neurology and Neurosurgery (NHNN) Botox clinic.

Design Case control study.

Subjects Subjects included CD patients attending the NHNN Botox clinic to receive injections.

Methods Injectors were educated about the Toronto Western Spasmodic Torticollis Rating pain subscale (TWSTRS) and subsequently incorporated it into their standard assessment of CD patients prior to injections. Surveys were created and disseminated to patients immediately following their appointment to assess their opinions of the clinical team. Information was entered into Microsoft Excel and analysed using appropriate statistical methods. Results were compared with a previous NHNN Botox clinic audit.

Results 42 surveys were collected in total from CD patients over a 4 week period. 36 patients (85.7%) reported pain associated with the condition. In comparison to an audit conducted in 2016, involving a similar sample size (n=40, with 28 reporting pain), a higher proportion of CD patients felt their pain was well understood by the clinical team (89.3% vs 94.4%). Furthermore, a higher proportion felt the team were competent in managing their pain (67.9% vs 94.4%).

Conclusions Our study supports the use of a TWSTRS pain subscale to improve CD patient satisfaction rates in the Botox clinic. Further studies are encouraged to validate these findings and determine other suitable pain scales for implementation.

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