title: Suboptimal anti-epilepsy drug use is common among indigenous patients with seizures presenting to the emergency department.
abstract: We aimed to explore the causes of higher than expected rates of Indigenous emergency department (ED) seizure presentations. A questionnaire was administered to adult patients presenting with seizure to an ED in Far North Queensland. Over 15 months, among 260 presentations with seizure (22% Indigenous), 50% non-Indigenous patients, and 45% Indigenous patients completed the questionnaire. Risk factors for alcohol misuse were common in both groups (50% Indigenous, 43% non-Indigenous; p = 0.50), as were rates of reported head injury (50% Indigenous, 44% non-Indigenous; p = 0.50). However, 47% Indigenous patients, compared to 19% non-Indigenous patients (p < 0.05) reported missing anti-epileptic tablets at least twice weekly, representing clinically relevant medication non-adherence. This was the first reported seizure presentation for 12% Indigenous patients and 26% non-Indigenous patients. We conclude that among ED seizure presentations, alcohol excess and prior head injury are commonly observed, in both Indigenous and non-Indigenous patients. However, Indigenous patients have higher rates of anti-convulsant non-adherence, likely contributing to ED presentations.
authors.affiliation: Department of Neurology, Austin Health, Heidelberg, Victoria, Australia.
authors.forename: Ian B
authors.initials: IB
authors.lastname: Wilson
authors.forename: Simon
authors.initials: S
authors.lastname: Hawkins
authors.forename: Stella
authors.initials: S
authors.lastname: Green
authors.forename: John S
authors.initials: JS
authors.lastname: Archer
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000208:ethnology; D000927:Anticonvulsants / Q000008:administration & dosage*; D015897:Comorbidity / Q000639:trends; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000208:ethnology; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D044382:Population Groups / Q000523:psychology; D012640:Seizures / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: D000927:Anticonvulsants