Would an automated booking program prevent delay in intravesical botulinum toxin injections
Dr Joshua Kealey (1), Mr Henry Yao (1), Dr Helen O'Connel (1), Mr Johan Gani (1), Dr Jack Crozier (1)
(1) Western Health, Melbourne, Australia
To determine if the method of rebooking repeat intravesical Botulinum Toxin (BoNT) is associated with treatment delay and relapse of symptoms in patients with overactive bladder (OAB) and interstitial cystitis (IC).
Clinicopathological data was collected from patients who underwent intravesical BoNT from three separate urological practices: one public hospital and two large private practices. The time from cessation of effect to rebooking of BoNT was recorded and correlated with the re-booking method to determine delay in rebooking. Rebooking methods were categorised into “Clinician to re-book after review”, “Patient to contact and re-book” and “Automatic booking”.
In total, 336 patients were included in the study. 336 patients underwent initial botox injection, 180 proceeded to second cycle and 152 to third cycle. 42% of cases had neurogenic OAB, 56.5% had idiopathic OAB and 1.5% had IC. Between the 1st and 2nd cycle 151 patients had both duration of effect and method of rebooking recorded.In the patient call cohort, 32.4% reported treatment delay compared to 37.3% in the clinician rebook cohort. Chi squared testing (p=0.64) found no difference in treatment delay between these 2 methods of rebooking. Between the 2nd and 3rd cycle, automatic rebooking only resulted in treatment delay in 8.3% of cases compared to 44.3% in alternative booking methods. Fisher’s exact testing (p=0.026) found a significant difference in treatment delay between these cohorts.
Rebooking of BoNT therapy is often associated with significant delay and prolonged symptom recurrence. Automatic rebooking of BoNT therapy after duration of effect is established is by far associated with the least delay to patients. Automatic booking reminder programs inclusive of both patients and clinicians may significantly reduce delay lengths and rates and improve quality of life for patients.