Approaches of Physicians across Turkey to Administer Botulinum Toxin Injections in Anticoagulated Patients
Küçük Resim Yok
Tarih
2015
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Dergi ISSN
Cilt Başlığı
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Antikoagulan tedavi almakta olan hastalarda botulinum toksin (BTX) uygulamaları ile ilgili ulusal veya uluslararası rehberlerin olmaması, klinisyenlerin farklı yaklaşımlar sergilemesine neden olmaktadır. Bu araştırmada, klinisyenlerin bu grup hastalarda BTX uygulama yaklaşımlarının ortaya konması amaçlanmıştır. Gereç ve Yöntemler: Türkiye'de spastisite tedavisinde BTX uygulayan klinisyenlere yönelik elektronik anket çalışması gerçekleştirildi. Bulgular: Ankete 80 klinisyen katıldı. Rutin pratikte kullanılan BTX enjeksiyon teknikleri açısından klinisyenlar arasında belirgin farklılıklar saptandı. Ankete katılan klinisyenlerin %7'si antikoagulan kullanan hastalarda asla BTX enjeksiyonu yapmadığını, %4'ü International Normalized Ratio (INR) değerini kontrol etmeksizin enjeksiyonu gerçekleştiridiğini, geriye kalan %89'u ise, enjeksiyonları INR kontrolü ile gerçekleştirdiğini belirtti. Güvenli INR değeri, %45'i tarafından <=2,0, %38'i tarafından <=2,5, %17'si tarafından ise <=3,0 olarak rapor edildi. Klinisyenlerin çoğu, antikoagulan kullanan hastalarda rutin enjeksiyon tekniklerinde değişiklik yaptıklarını rapor ettiler. Sonuç: Klinisyenlerin büyük çoğunluğu antikoagulan kullanan hastalarda BTX enjeksiyonu uygularken dikkatli davranmakta ve uygulamayı sınırlamaktadır. Bu grup hastalarda güvenli INR aralığının belirlenmesine ve konsensus geliştirilmesine yönelik ileri çalışmalar gereklidir
Objective: In the absence of national or international guidelines, physician approaches to administer botulinum toxin (BTX) injections in patients on an anticoagulant therapy may be variable. We aimed to document the preferences and attitudes of physicians for controlling the bleeding risk of BTX injections in anticoagulated patients. Material and Methods: An electronic survey of physicians across Turkey who practice BTX administration for spasticity management was conducted.Results: In total, 80 physicians participated in the survey. There was a wide variance regarding the type of guidance and needle they used for injecting BTX in their routine practice. Among the respondents, only 7% reported refusing to administer BTX injections in anticoagulated patients, whereas 4% reported performing the injections without controlling the International Normalized Ratio (INR) value. Of the remaining respondents, the safe INR value for BTX injections was reported as <=2.0 by 45%, <=2.5 by 38%, and <=3.0 by 17% respondents. Most of the physicians reported altering some portion of their routine injection technique in anticoagulated patients. Conclusion: A majority of physicians remain cautious and restrict the administration of BTX in some way for anticoagulated patients. Future studies are required to establish a safe INR value and to develop a consensus statement for BTX injections in this patient population
Objective: In the absence of national or international guidelines, physician approaches to administer botulinum toxin (BTX) injections in patients on an anticoagulant therapy may be variable. We aimed to document the preferences and attitudes of physicians for controlling the bleeding risk of BTX injections in anticoagulated patients. Material and Methods: An electronic survey of physicians across Turkey who practice BTX administration for spasticity management was conducted.Results: In total, 80 physicians participated in the survey. There was a wide variance regarding the type of guidance and needle they used for injecting BTX in their routine practice. Among the respondents, only 7% reported refusing to administer BTX injections in anticoagulated patients, whereas 4% reported performing the injections without controlling the International Normalized Ratio (INR) value. Of the remaining respondents, the safe INR value for BTX injections was reported as <=2.0 by 45%, <=2.5 by 38%, and <=3.0 by 17% respondents. Most of the physicians reported altering some portion of their routine injection technique in anticoagulated patients. Conclusion: A majority of physicians remain cautious and restrict the administration of BTX in some way for anticoagulated patients. Future studies are required to establish a safe INR value and to develop a consensus statement for BTX injections in this patient population
Açıklama
Anahtar Kelimeler
Rehabilitasyon
Kaynak
Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
61
Sayı
3