Medidas de calidad en la atención a pacientes con epilepsia en la consulta de neurología / Quality measures in neurology consult care for epileptic patients

Introducción: La epilepsia es una de las afecciones que con más frecuencia atendemos en las consultas externas de neurología. Métodos: Analizamos la aplicación en nuestro centro de las 8 medidas sobre calidad en el cuidado de pacientes con epilepsia propuestas por la Academia Americana de Neurología: tipo de crisis y frecuencia de crisis, etiología de la epilepsia o síndrome epiléptico, resultados electroencefalograma, neuroimagen, aconsejar sobre efectos adversos de los fármacos antiepilépticos, remisión de los casos de epilepsia refractaria, consejos sobre cuestiones de seguridad y a mujeres en edad fértil. Resultados: En la mayoría de los casos estaba documentado adecuadamente las 4 primeras medidas de calidad. En el 66% se había preguntado sobre efectos adversos de los fármacos en todas las visitas. En casi todas las epilepsias intratables se había propuesto o remitido aun centro de referencia quirúrgico para la valoración en algún momento de la enfermedad, aunque generalmente hacía más de 3 a˜nos de la propuesta. Un 37% de los pacientes habían sido aconsejados sobre cuestiones de seguridad y menos de la mitad de las mujeres con epilepsia en edad fértil habían recibido consejos relativos a anticonceptivos y embarazo al menos una vez al año. Conclusiones: Realizamos una atención adecuada de acuerdo con las medidas de calidad en muchos de los aspectos clínicos, pero debemos mejorar la administración de consejos e información necesaria para el cuidado del paciente con epilepsia en las diferentes etapas de la vida

Introduction: Epilepsy is one of the most frequently observed diseases in neurology outpatient care. Methods: We analysed our hospital’s implementation of the 8 epilepsy quality measures proposed by the American Academy of Neurology: documented seizure types and seizure frequency, aetiology of epilepsy or the epilepsy syndrome, review of EEG, MRI, or CT results, counselling about antiepileptic drug side effects, surgical therapy referral for intractable epilepsy, and counselling about epilepsy-specific safety issues and for women of childbearing age. Results: In most cases, the first four quality measures were documented correctly. In 66% of the cases, doctors had asked about any adverse drug effects during every visit. Almost all patients with intractable epilepsy had been informed about surgical options or referred to a surgical centre of reference for an evaluation at some point, although referrals usually took place more than 3 years after the initial proposal. Safety issues had been explained to 37% of the patients and less than half of women of childbearing age with epilepsy had received counselling regardingcontraception and pregnancy at least once a year. Conclusions: The care we provide is appropriate according to many of the quality measures, but we must deliver more counselling and information necessary for the care of epileptic patients in different stages of life

Quality measures in neurology consult care for epileptic patients.

INTRODUCTION: Epilepsy is one of the most frequently observed diseases in neurology outpatient care. METHODS: We analysed our hospital's implementation of the 8 epilepsy quality measures proposed by the American Academy of Neurology: documented seizure types and seizure frequency, aetiology of epilepsy or the epilepsy syndrome, review of EEG, MRI, or CT results, counselling about antiepileptic drug side effects, surgical therapy referral for intractable epilepsy, and counselling about epilepsy-specific safety issues and for women of childbearing age. RESULTS: In most cases, the first four quality measures were documented correctly. In 66% of the cases, doctors had asked about any adverse drug effects during every visit. Almost all patients with intractable epilepsy had been informed about surgical options or referred to a surgical centre of reference for an evaluation at some point, although referrals usually took place more than 3 years after the initial proposal. Safety issues had been explained to 37% of the patients and less than half of women of childbearing age with epilepsy had received counselling regarding contraception and pregnancy at least once a year. CONCLUSIONS: The care we provide is appropriate according to many of the quality measures, but we must deliver more counselling and information necessary for the care of epileptic patients in different stages of life.