Abstract：
BACKGROUND: Cervical dystonia (CD) is an isolated, focal, idiopathic dystonia affecting the neck and upper back. CD is usually treated by botulinum neurotoxin (BoNT) injections into the dystonic muscles; however, about 20% of people will discontinue BoNT therapy. This systematic review aimed to determine the barriers to satisfaction and facilitators that could improve satisfaction with BoNT therapy for people with CD.
METHODS: A database search for journal articles investigating satisfaction with BoNT treatment in CD identified seven qualitative studies and one randomised controlled trial. Results were grouped into \"direct\" and \"indirect\" barriers and facilitators.
RESULTS: The most reported direct barrier to satisfaction with BoNT was treatment non-response, reported by up to 66% of participants. Other direct barriers included negative side effects, early wearing-off of treatment effect and inexperience of the treating physician. Indirect barriers included limited accessibility to treatment (including cost) and personal choice. Direct facilitators of satisfaction with BoNT included relief of symptoms and flexible re-treatment intervals. Indirect facilitators included easy accessibility to treatment.
CONCLUSIONS: Despite BoNT having a discontinuation rate of only 20%, it appears a much greater proportion of people with CD are dissatisfied with this treatment. As BoNT is currently the main treatment offered to people with CD, efforts to improve treatment response rates, reduce side effects and make treatment more flexible and readily available should be adopted to improve the quality of life for people with CD.
METHODS: A database search for journal articles investigating satisfaction with BoNT treatment in CD identified seven qualitative studies and one randomised controlled trial. Results were grouped into \"direct\" and \"indirect\" barriers and facilitators.
RESULTS: The most reported direct barrier to satisfaction with BoNT was treatment non-response, reported by up to 66% of participants. Other direct barriers included negative side effects, early wearing-off of treatment effect and inexperience of the treating physician. Indirect barriers included limited accessibility to treatment (including cost) and personal choice. Direct facilitators of satisfaction with BoNT included relief of symptoms and flexible re-treatment intervals. Indirect facilitators included easy accessibility to treatment.
CONCLUSIONS: Despite BoNT having a discontinuation rate of only 20%, it appears a much greater proportion of people with CD are dissatisfied with this treatment. As BoNT is currently the main treatment offered to people with CD, efforts to improve treatment response rates, reduce side effects and make treatment more flexible and readily available should be adopted to improve the quality of life for people with CD.
摘要：
背景：宫颈肌张力障碍（CD）是一种孤立的，焦点，特发性肌张力障碍影响颈部和上背部。CD通常通过将肉毒杆菌神经毒素（BoNT）注射到肌张力障碍中来治疗；然而，约20%的人将停止BoNT治疗。这项系统评价旨在确定满意度的障碍和促进者，这些障碍可以提高CD患者对BoNT治疗的满意度。
方法：在数据库中搜索了调查对CD中BoNT治疗满意度的期刊文章，确定了7项定性研究和1项随机对照试验。结果分为“直接”和“间接”障碍和促进因素。
结果：报道最多的BoNT满意度的直接障碍是治疗无反应，多达66％的参与者报告。其他直接障碍包括负面副作用，治疗效果的早期磨损和治疗医生的缺乏经验。间接障碍包括治疗机会有限(包括费用)和个人选择。对BoNT满意的直接促进者包括症状的缓解和灵活的再治疗间隔。间接促进者包括易于获得治疗。
结论：尽管BoNT的停药率仅为20％，似乎有更多的CD患者对这种治疗不满意。由于BoNT目前是提供给CD患者的主要治疗方法，努力提高治疗反应率，减少副作用，使治疗更加灵活和容易获得，应采用，以提高CD患者的生活质量。
方法：在数据库中搜索了调查对CD中BoNT治疗满意度的期刊文章，确定了7项定性研究和1项随机对照试验。结果分为“直接”和“间接”障碍和促进因素。
结果：报道最多的BoNT满意度的直接障碍是治疗无反应，多达66％的参与者报告。其他直接障碍包括负面副作用，治疗效果的早期磨损和治疗医生的缺乏经验。间接障碍包括治疗机会有限(包括费用)和个人选择。对BoNT满意的直接促进者包括症状的缓解和灵活的再治疗间隔。间接促进者包括易于获得治疗。
结论：尽管BoNT的停药率仅为20％，似乎有更多的CD患者对这种治疗不满意。由于BoNT目前是提供给CD患者的主要治疗方法，努力提高治疗反应率，减少副作用，使治疗更加灵活和容易获得，应采用，以提高CD患者的生活质量。
