Abstracts

Patients with epilepsy and autism represent a complex group that require specialist treatment and care. At the National Centre for Epilepsy we experienced a high readmission rate for this patient group. Carers expressed uncertainty on how best to manage these patients and their seizures. The aim of this study was to develop an educational program to increase competence among carers, thereby reducing readmission to a specialist epilepsy hospital., Sixteen consecutive adult patients (7 women, 9 men) with autism and difficult to treat epilepsy admitted to the National Centre for Epilepsy, Sandvika, Norway, from 01.01.2004 to 12.31.2005 were included. A three-phase, standardized program was designed. This consisted of: 1) a pre-hospitalization visit to establish patient needs with regard to the management of epilepsy and psychosocial problems, 2) a hospitalization phase where the individual needs of the patient revealed in phase 1 were further defined. The carers were given specialized and individualized information about epilepsy and behavioural/psychosocial problems relating to their patient, and 3) a post-hospitalization phase consisting of an individual plan and a follow-up visit at home. A survey for carer satisfaction was performed 1 month after discharge., The main finding in this study is that only 1 of the 16 patients have so far been readmitted to the hospital (Mean observation time: 16.4 months, range: 8-33 months). The survey for carer satisfaction revealed that in 9 cases the carers felt that they managed the problems related to the patient[apos]s epilepsy better. In 11 cases, the initiatives suggested by the hospital were implemented at home. In 15 cases, the carers found that the defined needs of the patient established in the pre-hospital phase were adhered to., A new educational program aimed at increasing competence among carers of patients with epilepsy and autism was shown to be effective. The readmission rate to hospital was dramatically reduced. Carers and staff felt more secure and competent when dealing with this complex patient group.,