The process of developing a non-medical (advanced allied health) botulinum toxin A prescribing and injecting model of care in a public rehabilitation setting
Kathy Kuipers B C , Ruth Cox B C , Dominique Doherty B and Kathy Grudzinskas BA Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, QLD 4102, Australia.
B Division of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, QLD 4067, Australia.
C Corresponding author. Email: ruth.cox@health.qld.gov.au
Australian Health Review 37(5) 624-631 https://doi.org/10.1071/AH12008
Submitted: 4 December 2012 Accepted: 1 October 2013 Published: 8 November 2013
Abstract
Objective The aim of this paper was to describe the process undertaken to develop a non-medical (advanced allied health extended role) botulinum toxin A prescription and injection project for adults with upper and lower limb spasticity secondary to an acquired brain injury. The hypertonicity clinic in the present study was located in a metropolitan public hospital in Queensland where multidisciplinary services are provided by a rehabilitation specialist and an advanced occupational therapist and physiotherapist.
Methods The process of developing the model included establishing potential benefits for the role extension project and documentation of a project plan.
Results Project outcomes included the development of a relevant governance structure, a research evidence-based project evaluation framework, a draft research ethics application, delineation of the key eligibility criteria and competencies required for physiotherapist and occupational therapist prescribers, and a final project report.
Conclusion Non-medical prescribing has the potential to increase patient access to botulinum toxin A injection for the management of focal spasticity. A process that supports early patient engagement, extensive consultation with relevant stakeholders, a strong governance structure, a high-quality research project and a long lead time may maximise the potential for successful completion of advanced allied health role extension projects, including prescription and injection of botulinum toxin A.
What is known about the topic? Non-medical prescribing has been recommended as a strategy for facilitating responsive health care and addressing health workforce shortages in Australia and overseas.
What does this paper add? A detailed description of the process used to develop a non-medical prescribing and injecting project within a public hospital rehabilitation unit, as well as an analysis of the facilitators and barriers to progression.
What are the implications for practitioners? A process that supports early patient engagement, extensive consultation with relevant stakeholders, a strong governance structure, a high-quality research project and a long lead time may maximise the potential for successful completion of advanced allied health role extension projects, including prescription and injection of botulinum toxin A.
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