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

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.

• Authors: A Bertsche, A-J Dahse, M P Neininger, M K Bernhard, S Syrbe, R Frontini, W Kiess, A Merkenschlager, T Bertsche
• Journal: Klinische Padiatrie (Klin Padiatr) Vol. 225 Issue 5 Pg. 277-82 (Sep 2013) ISSN: 1439-3824 [Electronic] Germany
• PMID: 23946090 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: © Georg Thieme Verlag KG Stuttgart · New York.

Chemical References

• Anticonvulsants

Topics

• Adolescent
• Ambulatory Care
• Anticonvulsants (adverse effects, 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