研究者们谴责英国癫痫保健太糟
LONDON, Oct 18 (Reuters Health) - Seizures are poorly controlled in 6,000 of the 30,000 patients diagnosed with epilepsy in the UK each year, a new study published Thursday reports.
Researchers said about 2,000 patients in this group had one or more seizures every month, yet only two thirds of these patients were likely to switch medications in an attempt to achieve better control.
"The lack of change and the slowness to change are an indictment of current practice and suggest that too often an insouciant attitude is taken to early epilepsy," a team at the Institute of Neurology in London writes in the Journal of Neurology, Neurosurgery, and Psychiatry.
, http://www.100md.com
While it was impossible to say how many patients would have benefited from a more aggressive approach to treatment, "almost certainly some medical and social complications could have been avoided and perhaps even mortality," the authors report.
The researchers followed 564 newly diagnosed epilepsy patients for up to 14 years.
They acknowledge that the outcome of patients who did make treatment switches was not always good. One third of patients who did switch because of poor seizure control failed to gain control on the second drug. And only one sixth of those who switched because of poor control on the second drug obtained lasting control on the third.
, 百拇医药
The investigators found that among patients who were diagnosed with having epilepsy upon their first seizure, only 15% received immediate medication, reflecting the UK's conservative approach to single seizure management.
The researchers said this was in stark contrast with practice in the United States, where about 70% of such patients receive immediate drug treatment.
"Which is the most appropriate approach is controversial," the authors state. However, they note that because of high rates of subsequent seizure recurrence, more than 70% of UK patients ultimately received medication.
, 百拇医药
The study findings show that phenytoin and carbamazepine were the preferred first-line drugs. Each was used by more than one third of patients in the study. Valproate was used in one-fifth and phenobarbital in only a minority.
The researchers noted a reluctance to use newer medications, even in patients whose epilepsy resisted treatment.
"There is probably considerable room for improvement in the provision of epilepsy treatment in the UK," the team concludes.
SOURCE: Journal of Neurology, Neurosurgery, and Psychiatry 2001;71:632-637., 百拇医药
Researchers said about 2,000 patients in this group had one or more seizures every month, yet only two thirds of these patients were likely to switch medications in an attempt to achieve better control.
"The lack of change and the slowness to change are an indictment of current practice and suggest that too often an insouciant attitude is taken to early epilepsy," a team at the Institute of Neurology in London writes in the Journal of Neurology, Neurosurgery, and Psychiatry.
, http://www.100md.com
While it was impossible to say how many patients would have benefited from a more aggressive approach to treatment, "almost certainly some medical and social complications could have been avoided and perhaps even mortality," the authors report.
The researchers followed 564 newly diagnosed epilepsy patients for up to 14 years.
They acknowledge that the outcome of patients who did make treatment switches was not always good. One third of patients who did switch because of poor seizure control failed to gain control on the second drug. And only one sixth of those who switched because of poor control on the second drug obtained lasting control on the third.
, 百拇医药
The investigators found that among patients who were diagnosed with having epilepsy upon their first seizure, only 15% received immediate medication, reflecting the UK's conservative approach to single seizure management.
The researchers said this was in stark contrast with practice in the United States, where about 70% of such patients receive immediate drug treatment.
"Which is the most appropriate approach is controversial," the authors state. However, they note that because of high rates of subsequent seizure recurrence, more than 70% of UK patients ultimately received medication.
, 百拇医药
The study findings show that phenytoin and carbamazepine were the preferred first-line drugs. Each was used by more than one third of patients in the study. Valproate was used in one-fifth and phenobarbital in only a minority.
The researchers noted a reluctance to use newer medications, even in patients whose epilepsy resisted treatment.
"There is probably considerable room for improvement in the provision of epilepsy treatment in the UK," the team concludes.
SOURCE: Journal of Neurology, Neurosurgery, and Psychiatry 2001;71:632-637., 百拇医药