title: Primary care doctors' management behavior with respect to epilepsy in Kerala, southern India.
abstract: Although a majority of persons with epilepsy in developing countries are diagnosed, treated, and followed up by primary care doctors, few efforts have been made to examine their understanding with respect to epilepsy management. Through a questionnaire survey, we gathered information about the epilepsy management behavior of 500 primary care doctors distributed across the south Indian state of Kerala. Very few of them ever had diagnosed focal seizures, and the majority of them overutilize EEGs, prescribe continuous antiepileptic drug (AED) prophylaxis for febrile convulsions, use relatively expensive AEDs often in combination and in suboptimal doses, and did not know about alternate management options for AED-resistant epilepsies. A substantial proportion of the current large treatment gap in epilepsy in developing countries could be minimized by educating the primary care physicians about the diagnosis of epileptic seizures, cost-effective AED treatment, and need-based referral for specialized care.
authors.affiliation: R. Madhavan Nair Center for Comprehensive Epilepsy Care, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
authors.forename: Rajesh S
authors.initials: RS
authors.lastname: Iyer
authors.forename: Mangattuthodi
authors.initials: M
authors.lastname: Rekha
authors.forename: T Santhosh
authors.initials: TS
authors.lastname: Kumar
authors.forename: P Sankara
authors.initials: PS
authors.lastname: Sarma
authors.forename: Kurupath
authors.initials: K
authors.lastname: Radhakrishnan
mesh_terms: D000927:Anticonvulsants / Q000592:standards / Q000627:therapeutic use*; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007194:India / Q000453:epidemiology; D058007:Physicians, Primary Care / Q000523:psychology* / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012111:Residence Characteristics; D011795:Surveys and Questionnaires
chemical_list: D000927:Anticonvulsants