Abstracts

Rationale: The aim was to assess key clinical data as markers of quality of epilepsy treatment. Consequently, we registered prospectively key information about epilepsy treatment at every consultation patients had in the epilepsy clinic at the Copenhagen University Hospital North Zealand, Denmark. Methods: The epilepsy clinic at Copenhagen University Hospital North Zealand serves a population of 310.000 inhabitants. Since June 1, 2012, the neurologist filled out a form about each epilepsy patient at every visit to the out-patient epilepsy clinic. The form contained the following information: date of first seizure; date of last seizure; epilepsy diagnosis (ICD 10); seizure frequency; treatment code for each individual antiepileptic drug (AED); and the patients statement as to the occurrence of AED side effects. A secretary typed the data for each patient and each visit into the Danish National Hospital Register. The registered data are now retrieved and processed. Results: During the period from June 1 to December 31, 2012, 593 adult epilepsy patients were treated at the clinic corresponding to a quarter of the epilepsy patients in the population. The sex ratio was 48% women and 52% men. The commonest main diagnostic group was focal epilepsy with complex partial seizures with or without secondary generalization. The corresponding diagnoses G40.2 and G40.2A-E accounted for 52% of the patients. Another 7% had focal epilepsy with simple partial seizures (G40.1 and G40.1A-E). Only 8% had generalized idiopathic (genetic) epilepsy (G40.3 and G40.3 A-G). The groups G40.4-G40.8 contained 2% of the patients, whereas 31% of the epilepsy diagnoses were not classified with certainty (G40.9). Data on a smaller number of patients showed that the six most commonly used AEDs were (with number of patients in brackets) Lamotrigine (182), Valproate (63), Levetiracetam (63), Oxcarbazepine (36), Topiramate (20), and Carbamazepine (18). About a third of the patients (32%) had been seizure-free for more than a year, 33% had had 1-3 seizure days in the past year, 17% had 4-11 seizure days in the past year, 13% had seizures from once a month to once a week, and the remaining 6% of the patients had seizures more than once a week. At the consultations 42% of the patients claimed to have side effects of the AED treatment, whereas 58% stated that they had no side effects. Conclusions: Retrieval of clinical data on epilepsy out-patients registered systematically in the Danish National Hospital Register enables assessment of the quality of epilepsy treatment. The majority of patients had a focal epilepsy, Lamotrigine was by far the commonest AED, a third of the patients were seizure-free, and a third had 1-3 seizure days a year. It is remarkable that 42% stated the occurrence of AED side effects. More detailed analysis of the data is possible, and the development in the quality of epilepsy care can be monitored using data retrieval with intervals in the future.