Personal continuity and the care of patients with epilepsy in general practice.
BACKGROUND
So far no study has shown that patients with a chronic illness benefit from seeing the same doctor in general practice although many believe this to be so.


OBJECTIVE
Epilepsy was chosen as an example to test the hypothesis that if patients see the same doctor more often in general practice they are more likely to discuss personally important aspects of their illness.


METHODS
In this cross-sectional survey 99 patients aged 15-84 years with active epilepsy were interviewed at home and then their records were reviewed. The patients came from four large Southampton group practices, one with a strict personal list system and three with combined lists. Outcome measures included reported discussion of feelings about stopping medication, stigma and concealment and the patient's relationship with practice doctors. Continuity was assessed from the records.


RESULTS
Discussion of epilepsy was not significantly associated with continuity of doctor but was significantly associated with ease of talking to one or more doctors.


CONCLUSIONS
Encouraging patients with epilepsy to see the same doctor may be less important than improving doctors' communication skills and paying specific attention to the psychosocial aspects of epilepsy as well as to seizure control. It is recommended that a simple checklist including these items is used when a patient's care is reviewed.
Freeman
G K
GK
Primary Medical Care, University of Southampton.
Richards
S C
SC
D000293:Adolescent; D000328:Adult; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D004739:England; D004827:Epilepsy / Q000628:therapy*; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011795:Surveys and Questionnaires