The use of Botulinum Toxin Type A in patients in out-of-hospital intensive care in Germany—results from a multidisciplinary online survey

Despite its potential to facilitate care, to improve quality of life, and to promote participation in out-of-hospital intensive care, BoNT-A remains underused. Key requirements include education on multidisciplinary treatment of spasticity and sialorrhea, adequate reimbursement for BoNT-A administration, a coordinating role for the neurologist in the regulatory framework of out-of-hospital intensive care, and integration of BoNT-A in treatment guidelines are required. Further research should collect patient-level data on spasticity, dystonia, sialorrhea, and BoNT-A treatment, and examine healthcare delivery across different healthcare structures.