Abstract
The COVID-19 pandemic severely impacted the function of medical facilities and rehabilitation services worldwide, including toxin services delivering Botulinum toxin treatments for neuromuscular conditions such as spasticity, dystonia, and sialorrhea. The aim of this paper is to understand how toxin services have dealt with the situation and what strategies have been adopted to continue services. The recommendations are based on a virtual round table held with toxin services experts from different European countries who shared their experiences and discussed the best practices. The challenges for toxin services were reviewed based on the experts’ experiences and on relevant literature from 2020 and 2021. A set of recommendations and best practices were compiled, focusing firstly on guidance for clinical practice, including assessing patients’ health and risk status and the urgency of their treatment. Secondly, it was discussed how patients on botulinum toxin therapy can be cared for and supported during the pandemic, and how modern technology and tele-medicine platforms can be generally used to optimize effectiveness and safety of toxin treatments. The technological advances prompted by the COVID-19 crisis can result in better and more modern patient care in the future.
Highlights
The ongoing COVID-19 pandemic severely impacted the routine function of medical facilities and rehabilitation services worldwide [1,2,3], including toxin services delivering Botulinum toxin (BoNT) treatments for neuromuscular conditions
BoNT injections are the standard of care for focal spasticity [4,5] and dystonia [6,7]
While acute facilities, such as intensive care units (ICUs), were in the focus in the first months of the pandemic, out-patient facilities such as toxin clinics had to deal with closures and limitations to their services [10]
Summary
The ongoing COVID-19 pandemic severely impacted the routine function of medical facilities and rehabilitation services worldwide [1,2,3], including toxin services delivering Botulinum toxin (BoNT) treatments for neuromuscular conditions. As a result of the pandemic, and the measures to combat it, toxin services around the world saw a significant reduction in patient visits and BoNT injections in 2020. While acute facilities, such as intensive care units (ICUs), were in the focus in the first months of the pandemic, out-patient facilities such as toxin clinics had to deal with closures and limitations to their services [10]. In 2021, facilities have established a new way of working, and vaccination campaigns for staff and patients have been invaluable for resuming services. Clinics will not be returning to pre-pandemic ways of working any time soon
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