Just What Are Treatment Goals for People Living with Epilepsy?

What are the personal goals of treatment for patients with epilepsy? Are physicians tuned in? Melanie Adams, PA and colleagues compared what physicians think their patients’ treatment goals are versus what they actually are. They presented their most recent research findings today at the American Epilepsy Society 59th Annual meeting in Washington, DC.

“Seizure control in epilepsy has been thought to be the primary goal for both patients and clinicians. However, practitioners may not be fully aware of the goals epilepsy patients truly wish to attain, which was the impetus for our study”, said Adams.

Adams et al. surveyed 48 patients at the University of North Carolina Epilepsy Clinic. Patients were asked to list their primary goal for their epilepsy treatment, the number of antiepileptic drugs (AEDs) they used, and their seizure frequency.

Results

Forty-eight patients, 32 of whom were female, completed the survey. The subjects took an average of 2 AEDs and averaged one seizure per month. Patients were grouped by number of AEDs used and seizure frequency. Patients taking two or more AEDs were more likely to list seizure control as their primary treatment goal. They also found that patients who had more frequent seizures listed seizure control as their main goal for treatment. In addition, they found that patients taking one AED and who had fewer seizures were least likely to list seizure control as their primary goal.

“The unexpected findings from our study were the goals listed by patients who did not experience very frequent seizures, and those who were taking less than 2 AEDs. The most common goal listed in this group of patients was to find the cause of their epilepsy. They wanted to know why they had seizures”, said Adams.

When asked how gender may have impacted the results of the study Adams replied, “We did not specifically look at gender differences affecting treatment goals in this case, but would like to look at gender differences affecting goals, as well as how goals for treatment may differ between patients with epilepsy versus patients with other chronic neurological conditions. I suspect that males and females may prioritize differently.”

Implications of the Study

Adams hopes this study will encourage epilepsy practitioners to “consider the fact that all patients may not be seeking seizure freedom as their goal for treatment. We have assumed that our patients would choose seizure freedom over any other goal for treatment. Our study indicates that many patients have other goals, and we should listen to our patients when discussing what results they would like in regards to their epilepsy treatment.”

Her future goal as an epilepsy practitioner is to help establish a locus of control for patients so that they can have more input and some control over their own epilepsy treatment.

The abstract of this study is published in Epilepsia 2005, Vol. 46, Supplement 8, p.14.

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