Premium
Adjustment of treatment increases quality of life in patients with epilepsy: a randomized controlled pragmatic trial
Author(s) -
Uijl S. G.,
Uiterwaal C. S. P. M.,
Aldenkamp A. P.,
Carpay J. A.,
Doelman J. C.,
Keizer K.,
Vecht C. J.,
De Krom M. C. T. F. M.,
Van Donselaar C. A.
Publication year - 2009
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2009.02713.x
Subject(s) - medicine , randomized controlled trial , quality of life (healthcare) , epilepsy , adverse effect , intervention (counseling) , pediatrics , relative risk , clinical trial , antiepileptic drug , physical therapy , psychiatry , confidence interval , nursing
Background and purpose: Complaints about side‐effects of antiepileptic drugs (AEDs) may be overlooked in clinical practice. We assessed the value and risks of an active intervention policy for reported complaints in a randomized controlled pragmatic trial. Methods: This randomized controlled pragmatic trial included 111 adults treated for epilepsy in seven general hospitals. They were considered well‐managed by their treating physician, but reported moderate to severe complaints on a questionnaire (SIDAED, assessing SIDe effects in AED treatment). The intervention was adjustment of AED treatment (53 patients), either reduction of dose or switch of AED, versus continuation of treatment unchanged (58 control patients) during 7 months. Primary outcomes were quality of life (Qolie‐10) and complaints score. Secondary outcome measures were the occurrence of seizures or adverse events. Results: After 7 months, the relative risk (RR) for improvement in quality of life was 1.80 (1.04–3.12) for the intervention group compared to control and the RR of decrease in complaints was 1.34 (0.88–2.05). In 58% of patients randomized to adjustment, the medication had indeed been changed. Discussion: In conclusion, despite a possible risk of seizure recurrence, adjustment of drug treatment in well‐managed patients with epilepsy, who report considerable complaints, improves the quality of life.