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Educational and health outcomes of children and adolescents receiving antiepileptic medication: Scotland-wide record linkage study of 766 244 schoolchildren
Childhood epilepsy can adversely affect education and employment in addition to health. Previous studies are small or highly selective producing conflicting results. This retrospective cohort study aims to compare educational and health outcomes of children receiving antiepileptic medication versus...
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| Published in: | BMC public health 2019-05, Vol.19 (1), p.595-595, Article 595 |
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| creator | Fleming, Michael Fitton, Catherine A Steiner, Markus F C McLay, James S Clark, David King, Albert Mackay, Daniel F Pell, Jill P |
| description | Childhood epilepsy can adversely affect education and employment in addition to health. Previous studies are small or highly selective producing conflicting results. This retrospective cohort study aims to compare educational and health outcomes of children receiving antiepileptic medication versus peers.
Record linkage of Scotland-wide databases covering dispensed prescriptions, acute and psychiatric hospitalisations, maternity records, deaths, annual pupil census, school absences/exclusions, special educational needs, school examinations, and (un)employment provided data on 766,244 children attending Scottish schools between 2009 and 2013. Outcomes were adjusted for sociodemographic and maternity confounders and comorbid conditions.
Compared with peers, children on antiepileptic medication were more likely to experience school absence (Incidence Rate Ratio [IRR] 1.43, 95% CI: 1.38, 1.48), special educational needs (Odds ratio [OR] 9.60, 95% CI: 9.02, 10.23), achieve the lowest level of attainment (OR 3.43, 95% CI: 2.74, 4.29) be unemployed (OR 1.82, 95% CI: 1.60, 2.07), be admitted to hospital (Hazard Ratio [HR] 3.56, 95% CI: 3.42, 3.70), and die (HR 22.02, 95% CI: 17.00, 28.53). Absenteeism partly explained poorer attainment and higher unemployment. Girls and younger children on antiepileptic medication had higher risk of poor outcomes.
Children on antiepileptic medication fare worse than peers across educational and health outcomes. In order to reduce school absenteeism and mitigate its effects, children with epilepsy should receive integrated care from a multidisciplinary team that spans education and healthcare. |
| doi_str_mv | 10.1186/s12889-019-6888-9 |
| format | article |
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Record linkage of Scotland-wide databases covering dispensed prescriptions, acute and psychiatric hospitalisations, maternity records, deaths, annual pupil census, school absences/exclusions, special educational needs, school examinations, and (un)employment provided data on 766,244 children attending Scottish schools between 2009 and 2013. Outcomes were adjusted for sociodemographic and maternity confounders and comorbid conditions.
Compared with peers, children on antiepileptic medication were more likely to experience school absence (Incidence Rate Ratio [IRR] 1.43, 95% CI: 1.38, 1.48), special educational needs (Odds ratio [OR] 9.60, 95% CI: 9.02, 10.23), achieve the lowest level of attainment (OR 3.43, 95% CI: 2.74, 4.29) be unemployed (OR 1.82, 95% CI: 1.60, 2.07), be admitted to hospital (Hazard Ratio [HR] 3.56, 95% CI: 3.42, 3.70), and die (HR 22.02, 95% CI: 17.00, 28.53). Absenteeism partly explained poorer attainment and higher unemployment. Girls and younger children on antiepileptic medication had higher risk of poor outcomes.
Children on antiepileptic medication fare worse than peers across educational and health outcomes. In order to reduce school absenteeism and mitigate its effects, children with epilepsy should receive integrated care from a multidisciplinary team that spans education and healthcare.</description><identifier>ISSN: 1471-2458</identifier><identifier>EISSN: 1471-2458</identifier><identifier>DOI: 10.1186/s12889-019-6888-9</identifier><identifier>PMID: 31101093</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject><![CDATA[Absenteeism ; Absenteeism (Labor) ; Academic achievement ; Adolescent ; Adolescents ; Adult ; Anticonvulsants ; Anticonvulsants - therapeutic use ; Asthma ; Attention deficit hyperactivity disorder ; Censuses ; Child ; Child health ; Children ; Children & youth ; Cognition & reasoning ; Comorbidity ; Control ; Convulsions & seizures ; Databases, Factual ; Drug Prescriptions - statistics & numerical data ; Drug therapy ; Drugs ; Education ; Educational outcomes ; Educational Status ; Elementary school students ; Employment ; Epilepsy ; Epilepsy - drug therapy ; Epilepsy - epidemiology ; Feasibility studies ; Female ; Girls ; Health ; Health care ; Hospitalization - statistics & numerical data ; Humans ; Hyperactivity ; Injuries ; Lisdexamfetamine ; Male ; Medical personnel training ; Medical Record Linkage ; Morbidity ; Mortality ; Multiple births ; Odds Ratio ; Patient outcomes ; Pediatric epilepsy ; Pharmacy ; Population ; Population cohort ; Pregnancy ; Prescribing ; Prescription writing ; Record linkage ; Retrospective Studies ; Risk factors ; School attendance ; Schools ; Schools - statistics & numerical data ; Scotland - epidemiology ; Teenagers ; Unemployment ; Unemployment - statistics & numerical data ; Young Adult]]></subject><ispartof>BMC public health, 2019-05, Vol.19 (1), p.595-595, Article 595</ispartof><rights>COPYRIGHT 2019 BioMed Central Ltd.</rights><rights>2019. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s). 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c560t-d315ca8a7652b27512c09576e8a74b9100a1dee99e5cd0f45e4300b86929b643</citedby><cites>FETCH-LOGICAL-c560t-d315ca8a7652b27512c09576e8a74b9100a1dee99e5cd0f45e4300b86929b643</cites><orcidid>0000-0002-2185-4502</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525436/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2227354638?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31101093$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fleming, Michael</creatorcontrib><creatorcontrib>Fitton, Catherine A</creatorcontrib><creatorcontrib>Steiner, Markus F C</creatorcontrib><creatorcontrib>McLay, James S</creatorcontrib><creatorcontrib>Clark, David</creatorcontrib><creatorcontrib>King, Albert</creatorcontrib><creatorcontrib>Mackay, Daniel F</creatorcontrib><creatorcontrib>Pell, Jill P</creatorcontrib><title>Educational and health outcomes of children and adolescents receiving antiepileptic medication: Scotland-wide record linkage study of 766 244 schoolchildren</title><title>BMC public health</title><addtitle>BMC Public Health</addtitle><description>Childhood epilepsy can adversely affect education and employment in addition to health. Previous studies are small or highly selective producing conflicting results. This retrospective cohort study aims to compare educational and health outcomes of children receiving antiepileptic medication versus peers.
Record linkage of Scotland-wide databases covering dispensed prescriptions, acute and psychiatric hospitalisations, maternity records, deaths, annual pupil census, school absences/exclusions, special educational needs, school examinations, and (un)employment provided data on 766,244 children attending Scottish schools between 2009 and 2013. Outcomes were adjusted for sociodemographic and maternity confounders and comorbid conditions.
Compared with peers, children on antiepileptic medication were more likely to experience school absence (Incidence Rate Ratio [IRR] 1.43, 95% CI: 1.38, 1.48), special educational needs (Odds ratio [OR] 9.60, 95% CI: 9.02, 10.23), achieve the lowest level of attainment (OR 3.43, 95% CI: 2.74, 4.29) be unemployed (OR 1.82, 95% CI: 1.60, 2.07), be admitted to hospital (Hazard Ratio [HR] 3.56, 95% CI: 3.42, 3.70), and die (HR 22.02, 95% CI: 17.00, 28.53). Absenteeism partly explained poorer attainment and higher unemployment. Girls and younger children on antiepileptic medication had higher risk of poor outcomes.
Children on antiepileptic medication fare worse than peers across educational and health outcomes. In order to reduce school absenteeism and mitigate its effects, children with epilepsy should receive integrated care from a multidisciplinary team that spans education and healthcare.</description><subject>Absenteeism</subject><subject>Absenteeism (Labor)</subject><subject>Academic achievement</subject><subject>Adolescent</subject><subject>Adolescents</subject><subject>Adult</subject><subject>Anticonvulsants</subject><subject>Anticonvulsants - therapeutic use</subject><subject>Asthma</subject><subject>Attention deficit hyperactivity disorder</subject><subject>Censuses</subject><subject>Child</subject><subject>Child health</subject><subject>Children</subject><subject>Children & youth</subject><subject>Cognition & reasoning</subject><subject>Comorbidity</subject><subject>Control</subject><subject>Convulsions & seizures</subject><subject>Databases, Factual</subject><subject>Drug Prescriptions - statistics & numerical data</subject><subject>Drug therapy</subject><subject>Drugs</subject><subject>Education</subject><subject>Educational outcomes</subject><subject>Educational Status</subject><subject>Elementary school students</subject><subject>Employment</subject><subject>Epilepsy</subject><subject>Epilepsy - drug therapy</subject><subject>Epilepsy - epidemiology</subject><subject>Feasibility studies</subject><subject>Female</subject><subject>Girls</subject><subject>Health</subject><subject>Health care</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Hyperactivity</subject><subject>Injuries</subject><subject>Lisdexamfetamine</subject><subject>Male</subject><subject>Medical personnel training</subject><subject>Medical Record Linkage</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Multiple births</subject><subject>Odds Ratio</subject><subject>Patient outcomes</subject><subject>Pediatric epilepsy</subject><subject>Pharmacy</subject><subject>Population</subject><subject>Population cohort</subject><subject>Pregnancy</subject><subject>Prescribing</subject><subject>Prescription writing</subject><subject>Record linkage</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>School attendance</subject><subject>Schools</subject><subject>Schools - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMC public health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fleming, Michael</au><au>Fitton, Catherine A</au><au>Steiner, Markus F C</au><au>McLay, James S</au><au>Clark, David</au><au>King, Albert</au><au>Mackay, Daniel F</au><au>Pell, Jill P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Educational and health outcomes of children and adolescents receiving antiepileptic medication: Scotland-wide record linkage study of 766 244 schoolchildren</atitle><jtitle>BMC public health</jtitle><addtitle>BMC Public Health</addtitle><date>2019-05-17</date><risdate>2019</risdate><volume>19</volume><issue>1</issue><spage>595</spage><epage>595</epage><pages>595-595</pages><artnum>595</artnum><issn>1471-2458</issn><eissn>1471-2458</eissn><abstract>Childhood epilepsy can adversely affect education and employment in addition to health. Previous studies are small or highly selective producing conflicting results. This retrospective cohort study aims to compare educational and health outcomes of children receiving antiepileptic medication versus peers.
Record linkage of Scotland-wide databases covering dispensed prescriptions, acute and psychiatric hospitalisations, maternity records, deaths, annual pupil census, school absences/exclusions, special educational needs, school examinations, and (un)employment provided data on 766,244 children attending Scottish schools between 2009 and 2013. Outcomes were adjusted for sociodemographic and maternity confounders and comorbid conditions.
Compared with peers, children on antiepileptic medication were more likely to experience school absence (Incidence Rate Ratio [IRR] 1.43, 95% CI: 1.38, 1.48), special educational needs (Odds ratio [OR] 9.60, 95% CI: 9.02, 10.23), achieve the lowest level of attainment (OR 3.43, 95% CI: 2.74, 4.29) be unemployed (OR 1.82, 95% CI: 1.60, 2.07), be admitted to hospital (Hazard Ratio [HR] 3.56, 95% CI: 3.42, 3.70), and die (HR 22.02, 95% CI: 17.00, 28.53). Absenteeism partly explained poorer attainment and higher unemployment. Girls and younger children on antiepileptic medication had higher risk of poor outcomes.
Children on antiepileptic medication fare worse than peers across educational and health outcomes. In order to reduce school absenteeism and mitigate its effects, children with epilepsy should receive integrated care from a multidisciplinary team that spans education and healthcare.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>31101093</pmid><doi>10.1186/s12889-019-6888-9</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-2185-4502</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | BMC public health, 2019-05, Vol.19 (1), p.595-595, Article 595 |
| issn | 1471-2458 1471-2458 |
| language | eng |
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| source | PubMed Central (Open access); Publicly Available Content Database |
| subjects | Absenteeism Absenteeism (Labor) Academic achievement Adolescent Adolescents Adult Anticonvulsants Anticonvulsants - therapeutic use Asthma Attention deficit hyperactivity disorder Censuses Child Child health Children Children & youth Cognition & reasoning Comorbidity Control Convulsions & seizures Databases, Factual Drug Prescriptions - statistics & numerical data Drug therapy Drugs Education Educational outcomes Educational Status Elementary school students Employment Epilepsy Epilepsy - drug therapy Epilepsy - epidemiology Feasibility studies Female Girls Health Health care Hospitalization - statistics & numerical data Humans Hyperactivity Injuries Lisdexamfetamine Male Medical personnel training Medical Record Linkage Morbidity Mortality Multiple births Odds Ratio Patient outcomes Pediatric epilepsy Pharmacy Population Population cohort Pregnancy Prescribing Prescription writing Record linkage Retrospective Studies Risk factors School attendance Schools Schools - statistics & numerical data Scotland - epidemiology Teenagers Unemployment Unemployment - statistics & numerical data Young Adult |
| title | Educational and health outcomes of children and adolescents receiving antiepileptic medication: Scotland-wide record linkage study of 766 244 schoolchildren |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-06T19%3A30%3A42IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Educational%20and%20health%20outcomes%20of%20children%20and%20adolescents%20receiving%20antiepileptic%20medication:%20Scotland-wide%20record%20linkage%20study%20of%20766%20244%20schoolchildren&rft.jtitle=BMC%20public%20health&rft.au=Fleming,%20Michael&rft.date=2019-05-17&rft.volume=19&rft.issue=1&rft.spage=595&rft.epage=595&rft.pages=595-595&rft.artnum=595&rft.issn=1471-2458&rft.eissn=1471-2458&rft_id=info:doi/10.1186/s12889-019-6888-9&rft_dat=%3Cgale_doaj_%3EA586512644%3C/gale_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c560t-d315ca8a7652b27512c09576e8a74b9100a1dee99e5cd0f45e4300b86929b643%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2227354638&rft_id=info:pmid/31101093&rft_galeid=A586512644&rfr_iscdi=true |