Treatment of epilepsy in daily clinical practice: have outcomes improved over the past 10 years?

In the past decade, many new antiepileptic drugs have become available, but their influence on patient outcomes in daily practice is not well known. In a community-based study, we assessed changes in epilepsy treatment and outcomes over a 10-year period. We compared two cross-sectional community-bas...

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Published in:Journal of neurology 2013-11, Vol.260 (11), p.2736-2743
Main Authors: Wassenaar, Merel, van Heijl, Inger, Leijten, Frans S. S., van der Linden, Paul, Uijl, Sabine G., Egberts, A. C. G., Carpay, J. A.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Anticonvulsants - therapeutic use
Antiepileptic agents
Child
Clinical medicine
Complaints
Convulsions & seizures
Cross-Sectional Studies
Drugs
Epilepsy
Epilepsy - drug therapy
Epilepsy - epidemiology
Epilepsy - psychology
Female
Humans
Linear Models
Longitudinal Studies
Male
Medicine
Medicine & Public Health
Middle Aged
Neurology
Neuroradiology
Neurosciences
Original Communication
Pharmacy
Predictive Value of Tests
Quality of Life
Questionnaires
Surveys and Questionnaires
Time Factors
Treatment Outcome
Young Adult
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creator Wassenaar, Merel
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Egberts, A. C. G.
Carpay, J. A.
description In the past decade, many new antiepileptic drugs have become available, but their influence on patient outcomes in daily practice is not well known. In a community-based study, we assessed changes in epilepsy treatment and outcomes over a 10-year period. We compared two cross-sectional community-based samples that were obtained from the same Dutch suburban region in 2000 and 2010 using pharmacy records for recruitment, including 344 and 248 epilepsy patients, respectively. The main outcome was self-reported quality of life (QoL, using the QOLIE-31). Potential predictors of QoL (adverse effects, seizure control, seizure acceptability, demographic, epilepsy- or treatment-related determinants) were assessed by multivariable linear regression. New antiepileptic drugs were used by 9 % of patients in 2000 and 34 % in 2010, P  
doi_str_mv 10.1007/s00415-013-7058-0
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Potential predictors of QoL (adverse effects, seizure control, seizure acceptability, demographic, epilepsy- or treatment-related determinants) were assessed by multivariable linear regression. New antiepileptic drugs were used by 9 % of patients in 2000 and 34 % in 2010, P  &lt; 0.001. More than 80 % in both samples reported to be treated by a neurologist. We found no significant differences in QOLIE-31 scores (72.57 vs. 72.44), or in the proportion of patients with complete seizure control (51 vs. 54 %), between the two study samples. Seizure control and adverse effects were important independent predictors of quality of life, explaining 58 % of the variance. We found no evidence that in this community the QoL of epilepsy patients has improved in the last decade, despite unrestricted availability of healthcare resources, including accessibility to new AEDs. 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source Springer Nature:Jisc Collections:Springer Nature Read and Publish 2023-2025: Springer Reading List
subjects Adolescent
Adult
Aged
Aged, 80 and over
Anticonvulsants - therapeutic use
Antiepileptic agents
Child
Clinical medicine
Complaints
Convulsions & seizures
Cross-Sectional Studies
Drugs
Epilepsy
Epilepsy - drug therapy
Epilepsy - epidemiology
Epilepsy - psychology
Female
Humans
Linear Models
Longitudinal Studies
Male
Medicine
Medicine & Public Health
Middle Aged
Neurology
Neuroradiology
Neurosciences
Original Communication
Pharmacy
Predictive Value of Tests
Quality of Life
Questionnaires
Surveys and Questionnaires
Time Factors
Treatment Outcome
Young Adult
title Treatment of epilepsy in daily clinical practice: have outcomes improved over the past 10 years?
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