title: The process of developing a non-medical (advanced allied health) botulinum toxin A prescribing and injecting model of care in a public rehabilitation setting.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, QLD 4067, Australia.
authors.forename: Kathy
authors.initials: K
authors.lastname: Kuipers
authors.forename: Ruth
authors.initials: R
authors.lastname: Cox
authors.forename: Dominique
authors.initials: D
authors.lastname: Doherty
authors.forename: Kathy
authors.initials: K
authors.lastname: Grudzinskas
mesh_terms: D000488:Allied Health Personnel; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D006779:Hospitals, Public; D006801:Humans; D007267:Injections; D009128:Muscle Spasticity / Q000188:drug therapy*; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D009788:Occupational Therapy; D059825:Physical Therapists; D016730:Program Development; D015397:Program Evaluation; D011793:Queensland; D012380:Role
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A