Ambulatory care of children treated with anticonvulsants - pitfalls after discharge from hospital

Klin Padiatr. 2013 Sep;225(5):277-82. doi: 10.1055/s-0033-1345174. Epub 2013 Aug 14.

Abstract

Background: Anticonvulsants require special consideration particularly at the interface from hospital to ambulatory care.

Patients and method: Observational study for 6 months with prospectively enrolled consecutive patients in a neuropediatric ward of a university hospital (age 0-<18 years) with long-term therapy of at least one anticonvulsant. Assessment of outpatient prescriptions after discharge. Parent interviews for emergency treatment for acute seizures and safety precautions.

Results: We identified changes of the brand in 19/82 (23%) patients caused by hospital's discharge letters (4/82; 5%) or in ambulatory care (15/82; 18%). In 37/76 (49%) of patients who were deemed to require rescue medication, no recommendation for such a medication was included in the discharge letters. 17/76 (22%) of the respective parents stated that they had no immediate access to rescue medication. Safety precautions were applicable in 44 epilepsy patients. We identified knowledge deficits in 27/44 (61%) of parents.

Conclusion: Switching of brands after discharge was frequent. In the discharge letters, rescue medications were insufficiently recommended. Additionally, parents frequently displayed knowledge deficits in risk management.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Ambulatory Care*
  • Anticonvulsants / adverse effects*
  • Anticonvulsants / therapeutic use*
  • Child
  • Child, Preschool
  • Drug Substitution
  • Drug Therapy, Combination
  • Epilepsy / drug therapy*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Infant
  • Long-Term Care
  • Male
  • Medication Adherence
  • Parents / education
  • Patient Discharge*
  • Prospective Studies
  • Risk Management

Substances

  • Anticonvulsants