COMPLEMENTARY AND INTEGRATIVE MEDICAL THERAPIES FOR EPILEPSY: RESULTS OF A SURVEY OF THE AES MEMBERSHIP
Abstract number :
2.309
Submission category :
Year :
2003
Submission ID :
3860
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Kate Dunn, Steven C. Schachter, Robert Scholten, David M. Eisenberg Medical Education, Penn State College of Medicine, Hershey, PA; Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA; Division for Research and Education in Complemen
Complementary and integrative medical therapies (CIMT) are used by up to 42% of the U.S. population, especially for chronic conditions.1 Some herbs and dietary supplements have been reported to exacerbate seizures, as well as affect AED pharmacokinetics and tolerability.2 One study found that 24% of epilepsy patients used CIMT, particularly herbs, dietary supplements and massage, and less than 1 in 3 disclosed their use to the neurologist.3 We surveyed practicing neurologists of the AES to ascertain their opinions and knowledge regarding CIMT and their perceptions of the prevalence of CIMT use among their epilepsy patients.
Respondents were asked to estimate the percentage of their epilepsy patients who used CIMT, whether they administered/prescribed CIMT to their patients and/or referred patients for CIMT, whether they considered each of twenty different CIMT as a legitimate medical practice for epilepsy, and whether they knew enough about CIMT to discuss them with their patients.
469 surveys were received from practicing neurologists. Most respondents (82%) believed that [lt] 25% of their patients were using CIMT for treatment of epilepsy. The CIMT most often administered/prescribed by respondents were diet (35%), behavioral medicine (15%), and exercise (12%). Herbs/dietary supplements were administered/prescribed by 7%. The CIMT most often considered to be legitimate medical practices (LMP) for epilepsy were behavioral medicine (53% of respondents), diet (49%; many respondents added the word ketogenic), biofeedback (34%), relaxation (29%), exercise (22%), meditation (21%), and prayer (21%). Only 1 in 10 considered herbs/dietary supplements as LMP; the corresponding figure for massage was 6%. Physicians who considered particular CIMT to be LMP were more likely to refer patients for those therapies. For example, 16 of 41 (39%) physicians who considered herbs/dietary supplements as LMP referred patients for herbal therapy compared to 6 of 390 (2%) who did not consider herbal therapy as LMP. 70% of respondents reported not being knowledgeable enough about herbs/dietary supplements to discuss them with their epilepsy patients; up to two-thirds were similarly not knowledgeable about behavioral medicine (42%), dietary therapy (42%), exercise (65%), meditation (63%), and prayer (64%).
In this sample, the estimates of the prevalence of use of CIMT were consistent with a patient-centered study;3 however, those CIMT that patients most often use were not considered LMP by [ge]90% of the respondents, which could explain in part the reluctance of patients to disclose their CIMT use. The majority of neurologists acknowledged lacking knowledge about CIMT and epilepsy, especially those CIMT most often considered LMP and those most often used by epilepsy patients.
1. Eisenberg DM, et al. JAMA 1998;280:1569-75.
2. Spinella M. Epilepsy Behav 2001;2:524-32.
3. Peebles CT, et al. Epilepsy Behav 2000 Feb;1:74-7.