title: Improving patient retention after botulinum toxin type A treatment.
abstract: BACKGROUND
  Botulinum toxin treatments have been associated with consistently high patient satisfaction rates, but calculation of patient retention rates is not routinely performed. Retention measurements serve as critical indicators of clinical performance and can be optimized by evaluation of current office policies and implementation of strategies to improve patient retention.
  
  
  OBJECTIVE
  To investigate the reasons patients discontinue botulinum toxin treatments and to evaluate the effect of a single intervention intended to improve patient retention.
  
  
  METHODS
  A retrospective chart review was performed of all patients who received botulinum toxin injections in a private cosmetic dermatology practice over a 2-year time period to determine the patient retention rate. Patients who had discontinued botulinum toxin treatment after a single session were surveyed to discern their reasons for terminating treatment. A change in office policy was instituted wherein all patients who received their first botulinum toxin treatment were required to undergo a 2-week post-treatment evaluation to determine treatment effect and to receive touch-up treatment as necessary. Retention rates were calculated over the 1-year period immediately after initiation of the new policy.
  
  
  RESULTS
  The initial patient retention rate was 55%. The most common reasons cited for discontinuance of botulinum toxin treatments were procedural cost, patient failure to re-schedule, perceived lack of product longevity, and clinical effect falling short of expectations. After initiation of the mandatory 2-week post-treatment office evaluation, a 67% patient retention rate was achieved.
  
  
  CONCLUSIONS
  Managing patient expectations of botulinum toxin treatments and mandatory post-treatment appointments for evaluation of the initial procedure increase the patient retention rate.
authors.affiliation: Washington Institute of Dermatologic Laser Surgery, Washington DC 20037, USA.
authors.forename: Lucille
authors.initials: L
authors.lastname: White
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Tanzi
authors.forename: Tina S
authors.initials: TS
authors.lastname: Alster
mesh_terms: D001071:Appointments and Schedules; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D003357:Cosmetic Techniques / Q000191:economics; D005102:Health Expenditures; D006801:Humans; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D010342:Patient Acceptance of Health Care; D010352:Patient Dropouts; D017060:Patient Satisfaction; D012189:Retrospective Studies; D015595:Skin Aging / Q000187:drug effects; D013997:Time Factors
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A