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Predictors of and attitudes toward counseling about SUDEP and other epilepsy risk factors among Austrian, German, and Swiss neurologists and neuropediatricians.
- Source :
-
Epilepsia [Epilepsia] 2016 Apr; Vol. 57 (4), pp. 612-20. Date of Electronic Publication: 2016 Feb 22. - Publication Year :
- 2016
-
Abstract
- Objective: To examine the attitudes toward counseling about sudden unexpected death in epilepsy (SUDEP) and other epilepsy risk factors among Austrian, German, and Swiss neurologists and neuropediatricians, and to determine factors associated with not discussing SUDEP.<br />Methods: Questionnaires were sent to approximately 5,000 neurologists and neuropediatricians in 2014 regarding respondents' demographics, their working environments, and how often they discussed SUDEP, suicidal ideations on anticonvulsive medication, driving restrictions, and risks in daily life activities.<br />Results: In total, 519 surveys were completed (respondents' mean age: 45.5 years, 41.6% female, 66.9% adult neurologists, 31.0% neuropediatricians). A minority of 2.7% reported that they counseled all of their patients on SUDEP, 8.7% counseled most of the time (50-90%), 20.8% sometimes (10-49%), 44.5% rarely (1-9%), and 23.3% reported not counseling about SUDEP at all. In contrast, 92.9% reported that they counseled all patients about driving restrictions and 81.5% about risks in daily life activities. Suicidal ideations were discussed in 59.0% for some and in 3.3% for all patients, whereas 35.1% of respondents reported never discussing suicidal ideations. Independent predictors of not discussing SUDEP were no additional epilepsy training, no or uncertain SUDEP cases in the past, <10 years in practice, <25 epilepsy patients seen per quarter, and the opinion of a lack of consequences in SUDEP prevention. The opinion that SUDEP is a risk factor in particular patient groups and the attitude that all risks should be discussed predicted counseling on SUDEP.<br />Significance: Our findings show a discrepancy between guidelines and practice regarding the discussion of premature mortality due to SUDEP or suicidality. Both are not discussed at all by a substantial proportion of neurologists and neuropediatricians. This is in contrast to ubiquitous education about driving restrictions. Dissemination of knowledge among physicians about potential preventive strategies might increase the likelihood of discussion. Clinical practice guidelines are welcomed by the majority of physicians in this process.<br /> (Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.)
- Subjects :
- Adult
Austria epidemiology
Death, Sudden prevention & control
Epilepsy diagnosis
Epilepsy therapy
Female
Forecasting
Germany epidemiology
Humans
Male
Middle Aged
Neurology methods
Pediatrics methods
Risk Factors
Surveys and Questionnaires
Switzerland epidemiology
Attitude of Health Personnel
Counseling methods
Death, Sudden epidemiology
Epilepsy epidemiology
Patient Education as Topic methods
Physicians psychology
Subjects
Details
- Language :
- English
- ISSN :
- 1528-1167
- Volume :
- 57
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Epilepsia
- Publication Type :
- Academic Journal
- Accession number :
- 26899504
- Full Text :
- https://doi.org/10.1111/epi.13337