Abstracts

RATIONALE: We surveyed the neurology clinic population at Henry Ford Hospital to determine if patients knew the potential adverse effects of AED use on bone health and preventative interventions. We wanted to know if there were significant differences based on gender, race, or the indication for AED use (epilepsy versus other).
Objective: at the end of this activity participants should be able to discuss issues regarding patient education in AED associated bone loss and prevention.
METHODS: An anonymous, voluntary [dsquote]one minute[dsquote] survey was offered to every patient seen at 2 sites of the Henry Ford Neurology Clinic for 3 consecutive weeks in April 2002. Three groups were identified: those with AED exposure for epilepsy, those with AED exposure for reasons other than epilepsy, and those with no prior AED exposure. Replies from those with no AED exposure were used to compare fracture rates. Questions included specific AEDs used, whether health providers discussed bone health, recommended calcium/vitamin D or weight bearing exercise, patient compliance with recommendations, incidence of fractures, race, age, and gender. Responses were put in a database and analysis was performed with Pearson Correlations (Statistica[tm]).
RESULTS: 173 surveys were returned. 18.7% of surveys had some missing responses, but only 2 were excluded from analysis due to the lack of essential data. 69% were completed by women. 59.6% were Caucasian and 32.7% were African American. 23% of responders had epilepsy while 17.5% took AEDs for other reasons. Those with AED exposure for reasons other than epilepsy were as likely to be informed about bone health issues as those with AED exposure for epilepsy, but the rates were quite low for both groups (14.3% vs. 23.1%, p=.94). Those with AED exposure for reasons other than epilepsy were also as likely to be informed of preventative interventions against bone loss. African Americans likewise were as likely as Caucasians to be given information about AED bone loss(13.3% vs. 22%, p=.26), but less likely to be told about preventative interventions with calcium/vitamin D (6.7% vs. 43.9%, p=.003). Fracture rates did not differ based on gender, race, age, or rationale for AED use. An increased incidence of fracture was not seen in those taking AEDs. If patients were told to take supplements they were significantly more likely to do so (p [lt] .001).
CONCLUSIONS: Relatively few patients taking AEDs know the potential adverse effects of these medications on bone health. Significantly fewer African Americans were advised to take adequate calcium and vitamin D for prevention by their health care providers despite similar fracture rates to Caucasians on AEDs. This survey highlights the need for greater patient education in bone health, especially since patients are significantly more likely to take supplements if advised to do so.