Predictors of and attitudes toward counseling about SUDEP and other epilepsy risk factors among Austrian, German, and Swiss neurologists and neuropediatricians

Medientyp: E-Artikel
Titel: Predictors of and attitudes toward counseling about SUDEP and other epilepsy risk factors among Austrian, German, and Swiss neurologists and neuropediatricians
Beteiligte: Strzelczyk, Adam; Zschebek, Gerda; Bauer, Sebastian; Baumgartner, Christoph; Grond, Martin; Hermsen, Anke; Kieslich, Matthias; Krämer, Günter; Kurlemann, Gerhard; May, Theodor W.; Mayer, Thomas; Neubauer, Bernd A.; Pfäfflin, Margarete; Plecko, Barbara; Ryvlin, Philippe; Schubert‐Bast, Susanne; Stefan, Hermann; Trinka, Eugen; Knake, Susanne; Seifart, Carola; Rosenow, Felix
Erschienen: Wiley, 2016
Erschienen in: Epilepsia
Sprache: Englisch
DOI: 10.1111/epi.13337
ISSN: 0013-9580; 1528-1167
Schlagwörter: Neurology (clinical) ; Neurology
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Beschreibung: <jats:title>Summary</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>To examine the attitudes toward counseling about sudden unexpected death in epilepsy (<jats:styled-content style="fixed-case">SUDEP</jats:styled-content>) and other epilepsy risk factors among Austrian, German, and Swiss neurologists and neuropediatricians, and to determine factors associated with not discussing <jats:styled-content style="fixed-case">SUDEP</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Questionnaires were sent to approximately 5,000 neurologists and neuropediatricians in 2014 regarding respondents’ demographics, their working environments, and how often they discussed <jats:styled-content style="fixed-case">SUDEP</jats:styled-content>, suicidal ideations on anticonvulsive medication, driving restrictions, and risks in daily life activities.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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 <jats:styled-content style="fixed-case">SUDEP</jats:styled-content>, 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 <jats:styled-content style="fixed-case">SUDEP</jats:styled-content> 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 <jats:styled-content style="fixed-case">SUDEP</jats:styled-content> were no additional epilepsy training, no or uncertain <jats:styled-content style="fixed-case">SUDEP</jats:styled-content> cases in the past, <10 years in practice, <25 epilepsy patients seen per quarter, and the opinion of a lack of consequences in <jats:styled-content style="fixed-case">SUDEP</jats:styled-content> prevention. The opinion that <jats:styled-content style="fixed-case">SUDEP</jats:styled-content> is a risk factor in particular patient groups and the attitude that all risks should be discussed predicted counseling on <jats:styled-content style="fixed-case">SUDEP</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Significance</jats:title><jats:p>Our findings show a discrepancy between guidelines and practice regarding the discussion of premature mortality due to <jats:styled-content style="fixed-case">SUDEP</jats:styled-content> 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.</jats:p></jats:sec>
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