ORCID
- Lance Watkins: 0000-0002-0447-5906
- Rohit Shankar: 0000-0002-1183-6933
Abstract
Background: People with epilepsy are at increased risk of multiple co-morbidities that may influence risk of adverse outcomes including impact on quality of life and premature mortality. These risk factors include potentially modifiable clinical characteristics associated with sudden unexpected death in epilepsy (SUDEP). For services to tackle risk, the clinical complexity of the target epilepsy population needs to be defined. While this has been comprehensively studied in large, economically developed countries little knowledge of these issues exist in small economically developed countries, like Malta (population: 500,000). Methods: This was a single centre study focused exclusively on patients attending Gozo General Hospital (GGH) Malta. STROBE guidance for reporting cross sectional studies was used to design and report the study. This was a retrospective review of standard care and SUDEP and seizure risks provided to all adults (over 18 years) with epilepsy attending GGH (2018–2021). Results: The review identified 68 people and 92% were compliant with their anti-seizure medication. A fifth (21%) had an intellectual disability. Despite only one patient having a psychotic illness, 19% were on antipsychotic medication. Only 18% of patients had a specific epilepsy care plan, 6% nocturnal surveillance and none had received advice on SUDEP. Discussion: Patient outcomes may be improved with increasing rates of personalized epilepsy care plans, appropriate nocturnal surveillance and reducing the prescription of antipsychotic medication as it is associated with greater risk of mortality. Issues such as stigma and shame appear to play a significant role in small communities and their access to care.
DOI
10.1016/j.yebeh.2024.109795
Publication Date
2024-04-20
Publication Title
Epilepsy and Behavior
Volume
155
ISSN
1525-5050
Keywords
Antipsychotic, Island population, Service provision, Small country, SUDEP, Cross-Sectional Studies, Comorbidity, Sudden Unexpected Death in Epilepsy/epidemiology, Humans, Middle Aged, Risk Factors, Male, Epilepsy/epidemiology, Anticonvulsants/therapeutic use, Young Adult, Malta/epidemiology, Adolescent, Female, Adult, Retrospective Studies, Aged
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Shankar, R., Pace, A., Watkins, L., Fiott, D., Bassett, P., Laugharne, R., & James, C. (2024) 'Identifying co-morbidities and risk in people with epilepsy: The Maltese experience', Epilepsy and Behavior, 155. Available at: https://doi.org/10.1016/j.yebeh.2024.109795
