BoNT-A for spasticity and dystonia

Measure Purpose: Improve spasticity and dystonia by BoNT-A injection to allow better delivery of care and hygiene, improve tolerance to other treatments (such as orthoses and equipment to support posture), reduce pain from spasticity, and reduce disturbance of sleep from pain and spasticity

The numerator: Patients who were evaluated OR treated OR referred for BoNT-A injection

is divided by

The denominator: All patients < 18 years of age with moderate to severe localized/segmental spasticity or dystonia in the upper and/or lower extremities

Exclusions are removed from the denominator for:

• Patient/caregiver refuse
• BoNT-A is contraindicated
• Patient has established care with another neurology or non-neurology provider that can evaluate the need for and/or provide BoNT-A injections

Key Phrases

Examples of key phrases you could use to meet the measure:

• Evaluated for BoNT-A
• Treated with BoNT-A
• Referred for BoNT-A treatment

Measure Calculation Example

Dr. Rojas had 25 patients less than 18 years of age with severe localized/segmental spasticity and 14 with dystonia from January 1 to December 31 of the measurement year. This is the denominator. Two patients had established care with another provider who provides BoNT-A injections, three had their caregiver refuse this service. These five patients are removed from the denominator.

Of the remaining 34 patients, three were evaluated for BoNT-A injection and nine were referred to another provider for BoNT-A injection. This is the numerator.

Quality of care = (3+9)/(25+14-5). Dr. Rojas has a score of 35% for this measure.