Abstracts

Rationale: Recognize the doctors treatment habits. Map the general therapies for the treatment of epilepsy. Identify the proportion of patients with epilepsy at Slovak clinics. Methods: Methodology:Quantitative questionnaire Sample Size:125 respondents (Neurologists) Location:Slovak Republic Target Group:Neurologists Survey Data Collection:2008 Survey Data Evaluation:September 2009 - October 2009 Results: The patients with epilepsy in Slovakia are treated solely by neurologists. On average one neurologist examines 29 epilepsy outpatients per month. Most of the neurologists (83%) examine less than 5 patients with epilepsy per day. Total of 50% of neurologists need 30 - 40 minutes to execute the initial examination of an epilepsy patient. To do the same, 32 % of neurologists need 20 - 30 minutes and 18% of neurologists require more than 40 minutes. An ordinary medical visit to the neurologist takes 10 - 20 minutes in 62 % of the cases, 30% of such visits last for 20 - 30 minutes and 4 % of the visits take more than 30 minutes. Neurologists consider low drug compliance to be caused by the large scale of medication (54%). An epilepsy patient takes 1.6 anti-epileptic drugs (AED) in an average. Low compliance is also caused by the indiscipline of the patients (46%) and a complicated drug dosage (43%). Neurologists value AEDs mainly for their curative effect, good drug tolerance and minimal side effects. The doctors associate the state without epileptic seizures mostly with valproate (42%) and levetiracetam (25%). The first choice drug used to treat primary generalized seizures (79%) and juvenile myoclonic epilepsy (JME) (50%) is valproate. In 70% of the cases of partial seizures the doctors use carbamazepine as the first choice. Levetiracetam is the most used from the new generation AEDs to treat partial seizures and JME. When evaluating AEDs , pregabaline is considered to be inefficient (74%), lamotrigine has a complicated dosage (59%) and topiramate has an unfavorable side-effect profile (56%). zonisamide has an inconvenient price and is the least known among neurologists. Neurologists proceed differently in case the treatment doesn t result in improvement. Some of them supplement the first choice medication with the new generation AEDs (1/3), others (1/3) are adding a medication with a different curative mechanism. One quarter of neurologists have their own trusted scheme. Neurologists refrain from adding a medication with the same mechanism (3%) and solely send their patient to other clinic with a higher level of expertise (1%). When considering the medication, price and the producer of the drug are considered as the least important factors for neurologists. Conclusions: Therapeutic habits and routine practices in treatment of the epilepsy of the neurologists in Slovak Republic correspond to standard therapeutic algorithms.