Ambulatory care of children treated with anticonvulsants - pitfalls after discharge from hospital.
BACKGROUND
Anticonvulsants require special consideration particularly at the interface from hospital to ambulatory care.


METHODS
Observational study for 6 months with prospectively enrolled consecutive patients in a neuropediatric ward of a university hospital (age 0-<18 years) with long-term therapy of at least one anticonvulsant. Assessment of outpatient prescriptions after discharge. Parent interviews for emergency treatment for acute seizures and safety precautions.


RESULTS
We identified changes of the brand in 19/82 (23%) patients caused by hospital's discharge letters (4/82; 5%) or in ambulatory care (15/82; 18%). In 37/76 (49%) of patients who were deemed to require rescue medication, no recommendation for such a medication was included in the discharge letters. 17/76 (22%) of the respective parents stated that they had no immediate access to rescue medication. Safety precautions were applicable in 44 epilepsy patients. We identified knowledge deficits in 27/44 (61%) of parents.


CONCLUSIONS
Switching of brands after discharge was frequent. In the discharge letters, rescue medications were insufficiently recommended. Additionally, parents frequently displayed knowledge deficits in risk management.
Hospital for Children and Adolescents, Centre of Pediatric Research, University of Leipzig, Germany.
A
A
Bertsche
A-J
AJ
Dahse
M P
MP
Neininger
M K
MK
Bernhard
S
S
Syrbe
R
R
Frontini
W
W
Kiess
A
A
Merkenschlager
T
T
Bertsche
D000293:Adolescent; D000553:Ambulatory Care; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D008134:Long-Term Care; D008297:Male; D055118:Medication Adherence; D010290:Parents / Q000193:education; D010351:Patient Discharge; D011446:Prospective Studies; D012308:Risk Management
D000927:Anticonvulsants