Paediatric out-patient antiepileptic drug doses recorded in the medical charts are not reliable: implications for the notion of noncompliance.
There may be discrepancies between the antiepileptic drug (AED) doses the physician believes the patient is taking and what is actually taken. This prospective study assesses the extent of the problem in one paediatric epilepsy clinic. A questionnaire was administered to the parent or patient by the clinical nurse specialist (CNS) with the physician blind. All AED doses taken were recorded and the medical charts later reviewed by the CNS. Twenty-five unselected patients (1-16 years old) taking 40 AEDs were studied. Five per cent of current AED regimes were incorrectly documented in the charts. Furthermore the AEDs and doses taken had changed from those planned at the previous clinic visit for 44% of patients (30% of AEDs). Twenty per cent of patients had difficulty understanding the AED regime, even though 72% had it in writing. Although the discrepancies were not harmful, the unreliability of the medical charts' entries is demonstrated. Such errors could well be detrimental to patient care and are not simply a matter of non-compliance. Extra care needs to be taken to reduce these errors and studies of patient compliance should control for them.
Whitehouse
W
W
Department of Paediatric Neurology, Birmingham Children's Hospital, UK.
Morris
B
B
D000293:Adolescent; D000553:Ambulatory Care; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008501:Medical Records, Problem-Oriented / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D016312:Treatment Refusal / Q000706:statistics & numerical data
D000927:Anticonvulsants