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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
Author(s) -
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,
SchubertBast Susanne,
Stefan Hermann,
Trinka Eugen,
Knake Susanne,
Seifart Carola,
Rosenow Felix
Publication year - 2016
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.13337
Subject(s) - epilepsy , german , medicine , demographics , psychiatry , risk factor , pediatrics , demography , archaeology , sociology , history
Summary 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 . 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. 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 . 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.