Medical audit of the care of patients with epilepsy in one group practice

Abstract

The care given in a group practice to 47 patients with epilepsy was reviewed.Since 1960 all newly diagnosed patients had been referred for a specialist opinion and EEG before the diagnosis of epilepsy was confirmed.Patients were not being counselled sufficiently on the problems of epilepsy, and over half the patients considered themselves to be unacceptable to the rest of society.Less than half the patients were treated with a single drug; more could probably have achieved control with one drug and run fewer risks of drug interaction. Although consideration of the clinical condition and haematological results showed problems in only 38 per cent of the patients, the use of serum drug level estimation affected decisions on management in 70 per cent. I suggest that the more widespread use of serum drug levels would be of great value to general practitioners interested in the care of epileptics.In half the cases it was the patient and not the doctor who decided the frequency of consultations. Of 17 patients with problems, nine were not having regular follow-ups. Since patients with epilepsy maintain regular contact with their family practitioner by requests for repeat prescriptions, it should not be difficult for the doctor to exercise appropriate control of the care of his patients.