The impact of a citywide audit with educational intervention on the care of patients with epilepsy.

Full Abstract

The care of patients with epilepsy historically has been well documented to be poor. Previous attempts to improve care through education have been unsuccessful. The New GP Contract in the UK introduced epilepsy as a core quality indicator from April 2004. This prospective audit assesses the impact of an audit with educational intervention on the process of care of patients with epilepsy. The case notes of 610 patients, of all ages, with epilepsy on treatment, in 13 general practices serving Chester and surrounding area were reviewed before and 2 years after an intervention, comprising (a) the provision of a comprehensive template, (b) individualised categorisation for each patient and (c) an educational session led by a Neurologist. The overall review rate increased in the first year from 41 to 49% (p<0.0001) and by 2 years to 63% (p<0.0001). Documented remission rate increased from 29 to 43% (p<0.0001). Admissions to accident and emergency fell significantly (p=0.0026). There was no fall in the non-compliance rate. Forty five percent of patients with documented poor control were not under shared care. Issues highlighted in the audit generated 77 referrals. There were clear health gains in 62 (13%) individuals from referrals and practice interventions related to the audit. This original audit identified significant improvements in review rate, documented remission rate and beneficial outcomes in individual patients. The changes were attributable to both the educational intervention and the coincidental acceptance of the New GP Contract. Remaining problems include lack of shared care for patients with active epilepsy.

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Author information

Author/s: Minshall, I (I); Smith, D (D);

Affiliation: Northgate Village Surgery, Northgate Avenue, Chester CH2 2DX, United Kingdom. ian.minshall@gp-n81121.nhs.uk

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Seizure : the journal of the British Epilepsy Association (Seizure), published in England. (Language: eng)

Reference: 2008-Apr; vol 17 (issue 3) : pp 261-8

Dates: Created 2008/03/10; Completed 2008/06/24;

PMID: 17913517, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Anticonvulsants - therapeutic use
Commission on Professional and Hospital Activities
Epilepsy - drug therapy; epidemiology
Humans

Patient Care - standards
Patient Compliance - statistics & numerical data
Patient Education as Topic - standards
Primary Health Care - utilization
Risk Factors

Associated Chemicals: Anticonvulsants (0)

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