title: Differences between objective efficacy and perceived efficacy in patients with palmar hyperhidrosis treated with either botulinum toxin or endoscopic thoracic sympathectomy.
abstract: BACKGROUND
  Moderate to severe palmar hyperhidrosis can disturb people's work and social and emotional lives. Botulinum toxin and sympathectomy are currently considered the most effective treatment options but few studies have analysed the concordance between efficacy and patient satisfaction in comparisons of these two types of treatments.
  
  
  OBJECTIVE
  To assess the relation between efficacy and the satisfaction of patients with palmar hyperhidrosis treated with either botulinum toxin or endoscopic thoracic sympathectomy.
  
  
  METHODS
  This retrospective, observational study included all patients treated with either botulinum toxin or endoscopic thoracic sympathectomy in a single reference hospital in 2005-2010. Information was obtained from computerized medical records and a telephone survey about patients' educational and socio-economic level, awareness of treatment options, pre- and post-treatment severity of palmar hyperhidrosis, satisfaction and associated side effects. Predictors of efficacy and patient satisfaction with each treatment were analysed with ordinal and multinomial logistic regression models.
  
  
  RESULTS
  Patients who underwent sympathectomy had more severe palmar hyperhidrosis but efficacy and patient satisfaction were greater compared with patients given botulinum toxin. The severity of the compensatory palmar hyperhidrosis was predictive of less satisfaction after sympathectomy. In the group treated with botulinum toxin, low socio-economic status, lack of information about treatment options, fewer sessions and a shorter anhidrotic effect were associated with less satisfaction.
  
  
  CONCLUSIONS
  In studies of expectations regarding the outcome of palmar hyperhidrosis treatment, doctors should consider the factors that determine patient satisfaction in relation to the treatment options.
authors: Departments of Dermatology Thoracic Surgery, Reina Sofia University Hospital, Cordoba, Spain.
authors: M A
authors: MA
authors: Alvarez
authors: J
authors: J
authors: Ruano
authors: F J
authors: FJ
authors: Gómez
authors: E
authors: E
authors: Casas
authors: C
authors: C
authors: Baamonde
authors: A
authors: A
authors: Salvatierra
authors: J C
authors: JC
authors: Moreno
mesh_terms: D000293:Adolescent; D000328:Adult; D001905:Botulinum Toxins / Q000627:therapeutic use*; D002648:Child; D004724:Endoscopy; D005260:Female; D006225:Hand; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012923:Social Class; D013562:Sympathectomy / Q000379:methods*; D055815:Young Adult
chemical_list: D001905:Botulinum Toxins