title: A 3 year audit of adult epilepsy care in a Nigerian tertiary hospital (2011-2013).
abstract: BACKGROUND
  Epilepsy audit provides positive feedback to physicians that could assist in improving the quality of health care services provided for patients. This study was carried out to evaluate care given to people with epilepsy with the aim of determining potentials for improvement.
  
  
  METHODS
  Medical records of patients with uncomplicated epilepsy who have attended the neurology clinic at the University of Ilorin Teaching Hospital for not less 12 months between years 2011and 2013 were reviewed.
  
  
  RESULTS
  A total of 125 patients were as evaluated; of which 64 (51%) were males and 61 (49%) were females. Their median age was 26 (21-40) years and median seizure duration of 9 (4-15) years. Close to 65% of the patients were below 30 years of age. Most patients (68%) were referred by general practitioners/family physicians. Generalized epilepsy was the predominant seizure type seen in 73 (58%) patients. Majority of patients (76%) were on antiepileptic drug (AED) monotherapy, and 28 (22%) were on two AEDs combination. Eighty-one patients (64%) used carbamazepine either singly (63%) or in combination (18%) at an average dose of 600 mg/day. The two other common AEDs used were: Sodium valproate (45%) and phenobarbitone (9%). Fifty-one patients (41%) had good seizure control (no seizure in preceding 1 year), 34 (27%) had partial control (<12 attacks/year) and 41 (36%) had poor control (>1 attack/month). Overall, 66 patients (48%) had their medication changed between 2 and 3 times in the course of treatment, and the most common reason was poor seizure control. Twenty-one (21%) did not comply with the use of given AED.
  
  
  CONCLUSIONS
  Less than half of our patients had good epilepsy control. To improve on drug compliance attending physicians need to prescribe more of the relatively cheaper AED like the phenobarbitone and to optimize drug dosage before switching to another.
authors.affiliation: Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Kwara, Nigeria.
authors.forename: Emmanuel Olatunde
authors.initials: EO
authors.lastname: Sanya
authors.forename: Kolawole Wasiu
authors.initials: KW
authors.lastname: Wahab
authors.forename: Olufemi Olumuyiwa
authors.initials: OO
authors.lastname: Desalu
authors.forename: Hamsat Abiodun
authors.initials: HA
authors.lastname: Bello
authors.forename: Babatunde Ayodeji
authors.initials: BA
authors.lastname: Ademiluyi
authors.forename: Wemimo Adetunji
authors.initials: WA
authors.lastname: Alaofin
authors.forename: Kudirat
authors.initials: K
authors.lastname: Busari
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use*; D002220:Carbamazepine / Q000627:therapeutic use; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008485:Medical Audit; D055118:Medication Adherence; D008875:Middle Aged; D009549:Nigeria; D010342:Patient Acceptance of Health Care; D010634:Phenobarbital / Q000627:therapeutic use; D012640:Seizures / Q000188:drug therapy*; D014635:Valproic Acid / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine; D014635:Valproic Acid; D010634:Phenobarbital