title: Conversations between community-based neurologists and patients with epilepsy: results of an observational linguistic study.
abstract: An in-office linguistic study was conducted to assess neurologist-patient discussions of epilepsy. Naturally occurring interactions among 20 neurologists and 60 of their patients with epilepsy were recorded. Participants were interviewed separately postvisit. Transcripts were analyzed using sociolinguistic techniques. Of 59 patients taking antiepileptic drugs previsit, 44 (75%) discussed side effects with their neurologist. Side effect discussions were most often neurologist initiated. Postvisit, patients and neurologists often disagreed about which side effects were experienced. The presence of a caregiver (e.g., spouse) usually resulted in lengthier, more detailed discussions of side effects, without drastically increasing overall visit length. Discussions of mood- and behavior-related comorbidities occurred infrequently (14 of 60 visits); postvisit, neurologists stated that they felt that management of these conditions was outside their area of expertise. Communication gaps observed in discussions of epilepsy and its treatment warrant further exploration. Additional research is currently underway to assess the efficacy of a previsit assessment tool.
authors.affiliation: Comprehensive Epilepsy Center, Cornell University, New York, NY, USA.
authors.forename: Frank
authors.initials: F
authors.lastname: Gilliam
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Penovich
authors.forename: Corey A
authors.initials: CA
authors.lastname: Eagan
authors.forename: John M
authors.initials: JM
authors.lastname: Stern
authors.forename: David M
authors.initials: DM
authors.lastname: Labiner
authors.forename: Meaghan
authors.initials: M
authors.lastname: Onofrey
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Holmes
authors.forename: Eileen
authors.initials: E
authors.lastname: Mathis
authors.forename: Joyce
authors.initials: J
authors.lastname: Cramer
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects; D001291:Attitude of Health Personnel; D003142:Communication; D004827:Epilepsy / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological / Q000379:methods; D008037:Linguistics; D008297:Male; D008875:Middle Aged; D019370:Observation / Q000379:methods; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D012111:Residence Characteristics; D012189:Retrospective Studies
chemical_list: D000927:Anticonvulsants