030\u2005Management and attitudes towards persons with epilepsy in general practice: how far have we come?

Abstract

Introduction Previous surveys of general practitioners (GP) attitudes regarding epilepsy and people with epilepsy (PWE), conducted 20–30 years ago1\u20092, identified the need for further education in epilepsy care for GPs. This follow up study of GPs in Sydney, Australia, was conducted to determine the degree of changes in knowledge, attitudes and management of PWE, to evaluate if there had been significant improvement during this period. Methods A piloted questionnaire addressing epilepsy investigations, preferred care provider and attitudes towards epilepsy was developed and completed by a representative sample of Sydney GPs. Results A total of 52 completed responses were received. 36 out of 47 GPs (77%) chose neurologists as the most important care giver, followed by the GP (9/47; 18.7%), 25/51 respondents (49%) mentioned they never personally initiated anti-epileptic medication (AEM) and another 27% (14/51 GPs) rarely commenced AEM therapy. 6/50 GPs did not mention EEG as a routine investigation and 21/50 did not mention MRI as routine for PWE. The five most commonly prescribed AEMs, according to frequency were sodium valproate (42), carbamazepine (37), levetiracetam (31), lamotrigine (16) and phenytoin (15). Newer AEMs, available for over a decade in Australia were not mentioned. Emotional, behavioral psychosocial issues were perceived to be more common amongst PWE. Conclusion The study indicates little perceptual shift regarding GP’s attitudes to epilepsy, and significant deficiencies in knowledge, particularly with regards to investigations and management. The findings reinforce a need for more formal training of GPs caring for PWE. References Beran RG, Read T. A survey of doctors in Sydney, Australia: perspectives and practices regarding epilepsy and those affected by it. Epilepsia. 1983;24(1):79–104. Frith JF, Harris MF, Beran RG. Management and attitudes of epilepsy by a group of Sydney general practitioners. Epilepsia. 1994;35(6):1244–7.