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Telemedicine for Individuals with epilepsy: Recommendations from International League Against Epilepsy Telemedicine Task Force. Seizure 2023; 106:85-91. [PMID: 36803864 DOI: 10.1016/j.seizure.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
Worldwide, People with Epilepsy (PWE) are confronted with several barriers to face-to-face consultations. These obstacles hamper appropriate clinical follow-up and also increase the treatment gap for Epilepsy. Telemedicine holds the potential to enhance management as follow-up visits for PWE are focused on more on clinical history and counselling rather than physical examination. Besides consultation, telemedicine can also be used for remote EEG diagnostics and tele-neuropsychology assessments. In this article, the Telemedicine Task Force of the International League Against Epilepsy (ILAE) outlines recommendations regarding optimal practice in utilizing in the management of individuals with epilepsy. We formulated recommendations for minimum technical requirements, preparing for the first tele-consultation and the specificities for follow-up consultations. Special considerations are necessary for specific populations, including paediatric patients, patients who are not conversant with tele-medicine and those with intellectual disability. Telemedicine for individuals with epilepsy should be vigorously promoted with the aim of improving the quality of care and ultimately reduce the wide clinician access related treatment gap across several regions of the globe.
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Chou IJ, Chung TT, Liu YH, Hung PC, Lin JJ, Chiou MJ, See LC, Lin KL, Wang HS. Secular Trends in the Incidence, Prevalence, and Medications for Epilepsy from 2007 to 2015 in Taiwan: A Nationwide Population-Based Study. Neuroepidemiology 2021; 55:484-494. [PMID: 34781294 DOI: 10.1159/000519544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/08/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Patients with epilepsy have a higher mortality rate than the general population. Up-to-date estimates of epilepsy incidence, prevalence, and medication use are critical to assist policymaking. METHODS Using the National Taiwan Insurance Research Database, the standardized incidence and prevalence of epilepsy were estimated in each calendar year from 2007 to 2015. We used the incident cases of epilepsy to analyze the change in prescribing patterns from 2007 to 2015. Joinpoint regression was used to estimate secular trends. RESULTS From 2007 to 2015, the age- and sex-standardized incidence decreased from 0.72 (95% confidence interval [CI] 0.70-0.73) to 0.54 (95% CI 0.53-0.55) per 1,000 person-years, giving an annual percentage change (APC) of -2.73 (p < 0.05). Among patients younger than 20 years, the incidence did not change significantly. The age- and sex-standardized prevalence decreased from 6.94 (95% CI 6.90-6.98) to 6.86 (95% CI, 6.82-6.89) per 1,000 people, giving an APC of -0.31 (p < 0.05). However, the prevalence increased in the 35- to 49- and 50- to 64-year age-groups. The most common first-line anticonvulsant was phenytoin in 2007 and valproate in 2015. The use of levetiracetam, clobazam, and valproate increased during the study period, with APCs of 25.48% (95% CI 19.97-31.24), 6.41 (3.09-9.85), and 2.83 (1.51-4.16), respectively. The use of carbamazepine, phenytoin, and topiramate decreased; the APCs were -23.86% (95% CI -25.25 to -22.44), -6.61 (-8.40 to -4.79), and -4.29% (-7.87 to -0.57), respectively. CONCLUSIONS The overall prevalence and incidence of epilepsy decreased slightly from 2007 to 2015. The prescribed first-line anticonvulsant also changed over time.
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Affiliation(s)
- I-Jun Chou
- Division of Pediatric Neurology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine at Linkou, Taoyuan, Taiwan,
| | - Ting-Ting Chung
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yi-Hsuan Liu
- Division of Pediatric Neurology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine at Linkou, Taoyuan, Taiwan
| | - Po-Cheng Hung
- Division of Pediatric Neurology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine at Linkou, Taoyuan, Taiwan
| | - Jainn-Jim Lin
- Division of Pediatric Critical Care and Pediatric Neurocritical Care Center, Chang Gung Children's Hospital and Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan, Taiwan
| | - Meng-Jiun Chiou
- Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Lai-Chu See
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan.,Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kuang-Lin Lin
- Division of Pediatric Neurology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine at Linkou, Taoyuan, Taiwan
| | - Huei-Shyong Wang
- Division of Pediatric Neurology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine at Linkou, Taoyuan, Taiwan
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Farrukh MJ, Makmor-Bakry M, Hatah E, Jan TH. Impact of complementary and alternative medicines on antiepileptic medication adherence among epilepsy patients. BMC Complement Med Ther 2021; 21:50. [PMID: 33541336 PMCID: PMC7863518 DOI: 10.1186/s12906-021-03224-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 01/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to assess the knowledge, attitude, and practice of complementary and alternative medicine (CAM) and its impact on antiepileptic drug (AED) adherence among patients with epilepsy. METHODS A cross-sectional study was carried out on 100 epilepsy patients, aged 18 years or older that did not have any physical or psychiatric illness. A patient-administered questionnaire was used to assess their knowledge, attitude towards, practice, and perceived effectiveness (KAPP) of CAM. Established adherence assessment tools were used to determine patient medication adherence. RESULTS The prevalence of CAM usage was found to be at 58%. CAM was used more frequently by males (n = 32, 60.4%) than by females (n = 26, 55.3%; p = 0.609). The most commonly used CAM included vitamins and minerals (36%), ginseng (16%), antioxidants (15%), and acupuncture (12%). A significant number of patients had low knowledge of (59%) and a positive attitude (54%) toward complementary and alternative medicine. Main reasons for using CAM were a lower price, better availability, and inadequate seizure control by AEDs. About 43% of the patients who used CAM informed their doctor. Prevalence of non-adherence to AED therapy was found to be 68%. A significant association was found between non-adherence and CAM usage (p < 0.01). CONCLUSION A high prevalence of CAM usage and non-adherence to AEDs among epilepsy patients was identified. CAM usage was associated with a non-adherence to AED therapy. This study highlights the need to explore CAM usage with patients before making clinical decisions to achieve the best outcomes from AED therapy.
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Affiliation(s)
- Muhammad Junaid Farrukh
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.,Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Mohd Makmor-Bakry
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.
| | - Ernieda Hatah
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Tan Hui Jan
- Faculty of MedicinePusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
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Bosak M, Słowik A. Use of complementary and alternative medicine among adults with epilepsy in a university epilepsy clinic in Poland. Epilepsy Behav 2019; 98:40-44. [PMID: 31299531 DOI: 10.1016/j.yebeh.2019.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/02/2019] [Accepted: 06/02/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The use of complementary and alternative medicine (CAM) is becoming increasingly prevalent both in general population and patients with chronic diseases. The aim of the study was to determine the prevalence, reasons, and factors influencing the use of CAM in Polish patients with epilepsy (PWE). MATERIAL AND METHODS This prospective study involved PWE treated in a university epilepsy clinic. Data on epilepsy, antiepileptic drugs, level of education, vocational activity, and patterns of CAM were collected from a structured interview and from medical records. RESULTS The sample population consisted of 473 PWE (mean age: 35.3 years); 220 (46.5%) were females, and 228 (46.5%) were in remission. Overall 26.8% (127) of the cohort used at least one type of CAM. The CAM modalities most frequently used were herbal and dietary supplements (32.3%), energy healing (31.5%), and marijuana (27.6%). The internet was the most common source of information on CAM (45.7%). In one-third of subjects, CAM usage affected negatively compliance to standard treatment. Logistic regression analysis revealed several independent risk factors for CAM use in PWE: younger age, longer duration of epilepsy, lack of remission, and lower level of education. CONCLUSION A significant proportion of PWE uses CAM, and its usage may affect negatively compliance to standard treatment. Our findings highlight poor communication between patients and physicians with regard to CAM use. Healthcare professionalists should routinely check for CAM utilization in PWE to prevent potential harm related to its use.
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Affiliation(s)
- Magdalena Bosak
- Dept. of Neurology, Jagiellonian University Medical College, Krakow, Poland.
| | - Agnieszka Słowik
- Dept. of Neurology, Jagiellonian University Medical College, Krakow, Poland
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Explanatory factors of adherence to community-based management of epilepsy in Lao PDR. Epilepsy Behav 2018; 88:74-80. [PMID: 30241057 DOI: 10.1016/j.yebeh.2018.08.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 08/27/2018] [Accepted: 08/27/2018] [Indexed: 11/21/2022]
Abstract
RELEVANCE A low level of knowledge about epilepsy among health workers, a context of stigmatizing sociocultural beliefs, and a low availability of antiepileptic drugs in Lao People's Democratic Republic (PDR) are major gaps in the medical management of people with epilepsy in this country. OBJECTIVES The principal objective of the study was to identify the associated factors of adherence to community healthcare structures in Lao PDR. Specific objectives were to evaluate patients' adherence status, practices and knowledge about epilepsy and its care, and factors influencing decision-making on therapeutic interventions. MATERIALS AND METHODS The study was an observational cross-sectional survey about knowledge, attitudes, and practices, handled from February to May 2016. Eighty-seven people with epilepsy were identified in two areas in the periphery of Vientiane Capital through an active screening in villages and homes. Semidirective questionnaires were conducted to collect quantitative and qualitative data. Quantitative analysis included a comparison of adherent vs. nonadherent people with epilepsy, using Chi-square or Fisher's test. Advanced qualitative lexical analysis was carried out on the open-ended questions. RESULTS Sixty-two people with epilepsy were included and the adherence rate to community care was 67.7%. The only sociodemographic variable that differed significantly between adherent and nonadherent members was the income level (p = 0.015): the wealthiest class of people with epilepsy did not adhere to community healthcare. Eleven percent of people with epilepsy thought that epilepsy was contagious, 80.6% that medication may reduce epilepsy seizure rates, and 33.9% that it was possible to cure epilepsy permanently. Physicians informed about the disease in 69.0% of adherent people with epilepsy and in 40.0% of nonadherent ones (p = 0.029), whereas villagers were involved in 29.0% and 50.0% of cases, respectively. There was a significant difference between the two groups for the prescribed antiepileptic drugs (p = 0.012): phenobarbital covered 73.8% of adherent people with epilepsy but only 40% of nonadherent ones. Half of nonadherent people with epilepsy went regularly to a central hospital in the Vientiane Capital, 15.0% went to Thailand, and 10.0% practiced self-medication in occasional mobilities. CONCLUSION A wider range of antiepileptic drugs at a reduced cost and the promotion of adherence to community healthcare would allow a better management of people with epilepsy in Lao PDR.
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Fadare JO, Sunmonu TA, Bankole IA, Adekeye KA, Abubakar SA. Medication adherence and adverse effect profile of antiepileptic drugs in Nigerian patients with epilepsy. Neurodegener Dis Manag 2018; 8:25-36. [DOI: 10.2217/nmt-2017-0044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Aim: Medication adherence remains a major challenge among patients with epilepsy (PWE) with the adverse effect profile of antiepileptic drugs (AEDs) as one of its main drivers. Methods: This was a cross-sectional questionnaire-based study among PWE in selected Nigerian tertiary healthcare facilities using the Morisky Medication Adherence Scale and the Liverpool Adverse Effect Profile (LAEP). Results: 126 PWE from four tertiary healthcare facilities were included in this study comprising of 59 (46.8%) males and 67 (53.2%) females. Carbamazepine (104/70.7%), sodium valproate (23/15.6%) and phenytoin (11/7.5%) were the most commonly prescribed AEDs. Using the Morisky Medication Adherence Scale, 17.2, 38.3 and 44.5% of patients were classified as having high, medium and low adherence, respectively. The mean LAEP score was 23.69 ± 6.07. The most common reported adverse effects among respondents were tiredness (30.4%) and headache (22.5%). Conclusion: Medication adherence to AED was poor among patients in this study.
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Affiliation(s)
- Joseph O Fadare
- Department of Pharmacology & Therapeutics, College of Medicine, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
| | - Taofiki A Sunmonu
- Neurology Unit, Department of Medicine, Federal Medical Centre, Owo, Ondo State, Nigeria
| | - Idowu A Bankole
- Neurology Unit, Department of Medicine, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Kehinde A Adekeye
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Sani A Abubakar
- Neurology Unit, Department of Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
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Farrukh MJ, Makmor-Bakry M, Hatah E, Tan HJ. Use of complementary and alternative medicine and adherence to antiepileptic drug therapy among epilepsy patients: a systematic review. Patient Prefer Adherence 2018; 12:2111-2121. [PMID: 30349205 PMCID: PMC6188960 DOI: 10.2147/ppa.s179031] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
PURPOSE To identify the use pattern of complementary and alternative medicine (CAM) and its impact on antiepileptic drug (AED) adherence among patients with epilepsy. METHOD Potential studies were identified through a systematic search of Scopus, Science Direct, Google Scholar, and PubMed. The keywords used to identify relevant articles were "adherence," "AED," "epilepsy," "non-adherence," and "complementary and alternative medicine." An article was included in the review if the study met the following criteria: 1) conducted in epilepsy patients, 2) conducted in patients aged 18 years and above, 3) conducted in patients prescribed AEDs, and 4) patients' adherence to AEDs. RESULTS A total of 3,330 studies were identified and 30 were included in the final analysis. The review found that the AED non-adherence rate reported in the studies was between 25% and 66%. The percentage of CAM use was found to be between 7.5% and 73.3%. The most common reason for inadequate AED therapy and higher dependence on CAM was the patients' belief that epilepsy had a spiritual or psychological cause, rather than primarily being a disease of the brain. Other factors for AED non-adherence were forgetfulness, specific beliefs about medications, depression, uncontrolled recent seizures, and frequent medication dosage. CONCLUSION The review found a high prevalence of CAM use and non-adherence to AEDs among epilepsy patients. However, a limited number of studies have investigated the association between CAM usage and AED adherence. Future studies may wish to explore the influence of CAM use on AED medication adherence.
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Affiliation(s)
| | - Mohd Makmor-Bakry
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
| | - Ernieda Hatah
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
| | - Hui Jan Tan
- Faculty of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
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Abstract
OBJECTIVES This study aimed to assess patients' healthcare-seeking preferences in mild, chronic, and serious illness; identify influential factors; and examine the reasons underlying patients' healthcare-seeking preference. DESIGN A retrospective study. SETTING The study was conducted in 14 tertiary hospitals in Shanghai, China. PARTICIPANTS Questionnaires were distributed to 1519 patients, and 1114 were completed and returned. All patients participated in the study voluntarily, provided written informed consent, and possessed the ability to complete the questionnaire. MAIN OUTCOME MEASURES We measured and compared preferences and choice of healthcare providers in patients if they had experienced mild, chronic, or serious illness. RESULTS More than 50% of participants, including those who were >60 years of age, had consulted a doctor more than three times during the preceding year, were single, and were most likely to decide not to seek medical treatment. Community health facilities were the most frequently selected healthcare provider in mild illness. In addition, patients who had no personal preference, did not express a preference for a good environment or first-class medical technology, were concerned about close proximity and short waiting times, and pursued low medical costs were most likely to choose a community health facility. General hospitals were the most frequently selected healthcare provider in chronic and serious illness. In addition, patients who earned higher monthly incomes, did not pursue low medical costs, were not concerned about short waiting times or close proximity, and expressed a preference for first-class medical technology, were most likely to choose general hospitals. CONCLUSION Patients' healthcare-seeking preference was influenced mainly by healthcare providers' characteristics, illness severity, and sociodemographic characteristics. These findings indicate that patients' current healthcare-seeking preference was not ideal and requires optimisation.
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Affiliation(s)
- Wenya Yu
- Department of Military Health Service Management, College of Military Health Service Management, Second Military Medical University, Shanghai, China
| | - Meina Li
- Department of Military Health Service Management, College of Military Health Service Management, Second Military Medical University, Shanghai, China
| | - Feng Ye
- Department of Medical Affairs, No. 187th hospital of PLA, Haikou, China
| | - Chen Xue
- Department of Military Health Service Management, College of Military Health Service Management, Second Military Medical University, Shanghai, China
| | - Lulu Zhang
- Department of Military Health Service Management, College of Military Health Service Management, Second Military Medical University, Shanghai, China
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Chou CC, Yen DJ, Lin YY, Wang YC, Lin CL, Kao CH. Selective Serotonin Reuptake Inhibitors and Poststroke Epilepsy: A Population-Based Nationwide Study. Mayo Clin Proc 2017; 92:193-199. [PMID: 28160872 DOI: 10.1016/j.mayocp.2016.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 09/26/2016] [Accepted: 10/11/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate the effects of selective serotonin reuptake inhibitors (SSRIs) on poststroke epilepsy in a population-based nationwide study. PATIENTS AND METHODS The SSRI group included patients who received a stroke diagnosis from January 1, 2000, through December 31, 2009, and were prescribed SSRIs after stroke. The non-SSRI group enrolled patients with stroke who were not prescribed SSRIs from the Taiwan National Health Insurance Research Database and used propensity score matching based on the index year, duration time, sex, age, type of stroke, and duration of hospitalization. Cox proportional hazards models were used to estimate the risk of epilepsy between the SSRI and comparison groups. RESULTS A total of 4688 patients with stroke (2344 in each of the SSRI and non-SSRI cohorts) were enrolled. The cumulative incidence of epilepsy in the SSRI group was significantly higher than that in the comparison group (log-rank P<.001). In the SSRI group, the risk of poststroke epilepsy increased 2.45-fold (95% CI, 1.69- to 3.57-fold) compared with that in the comparison group. Furthermore, the risk of poststroke epilepsy increased with the defined daily dose of SSRIs. For patients with ischemic stroke, SSRIs users had a 2.74-fold higher risk of epilepsy than non users (95% CI, 1.79- to 4.22-fold). CONCLUSION In this study, SSRI users had a higher risk of poststroke epilepsy than nonusers. Further study is warranted to investigate the causal relationship between SSRI exposure and poststroke epilepsy.
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Affiliation(s)
- Chien-Chen Chou
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Der-Jen Yen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yung-Yang Lin
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Chiao Wang
- College of Medicine, China Medical University, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan; Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
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Cai L. Traditional Chinese Herbal Medicine for Epilepsy Treatment Should Be Administered According to the Seizure Type and Epileptic Syndrome. Health (London) 2017. [DOI: 10.4236/health.2017.98087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Yeon GM, Nam SO. The use of complementary and alternative medicine in children with common neurologic diseases. KOREAN JOURNAL OF PEDIATRICS 2016; 59:313-8. [PMID: 27610179 PMCID: PMC5014910 DOI: 10.3345/kjp.2016.59.8.313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 09/05/2016] [Accepted: 09/26/2016] [Indexed: 11/27/2022]
Abstract
Complementary and alternative medicine (CAM) is a phrase used to describe additional health care methods such as mind/body practices and natural products not regarded as treatments by conventional medicine. The use of CAM in children with common neurologic diseases is more frequent than its use in healthy children (24%–78% vs. 12%). However, less than half of patients report such use to their physicians. The preferred modalities of CAM vary in different countries due to their different cultures and traditions. The most common factor significantly associated with the use of CAM is parental CAM use in most studies. The frequency of the use of CAM in children and adults with neurologic diseases is similar, and both rates are higher than the rates in those without these conditions. The preferred modalities of CAM in adults are diverse, and megavitamins and mind/body therapy (prayer and chiropractic care) are included. The most common factor significantly associated with the use of CAM in adults with neurologic diseases is high educational level. Physicians need to be concerned with patients' use of CAM and provide correct information about CAM so that patients may make the right decisions. Further study is needed to determine the evidence-based efficacy of CAM use in children with common neurologic diseases.
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Affiliation(s)
- Gyu-Min Yeon
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Sang Ook Nam
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea
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Complementary and alternative medicines use among pediatric patients with epilepsy in a multiethnic community. Epilepsy Behav 2016; 60:68-74. [PMID: 27179195 DOI: 10.1016/j.yebeh.2016.04.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 03/18/2016] [Accepted: 04/02/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Prior studies highlighted that patients on chronic medications who used complementary and alternative medicines (CAMs) did not share this information with their healthcare providers. Furthermore, there might be potential adverse interactions between CAMs and antiepileptic drug (AED) therapy. However, there are no studies that investigate the effect of religion or race on CAM use in a multiethnic community. Therefore, we aimed to investigate CAM usage among pediatric patients with epilepsy (PPE) and identify predictors of CAM usage in our multiethnic setting. METHODS This was a cross-sectional study where caregivers of recruited at an outpatient epilepsy clinic between September 2013 and July 2014 completed a self-administered survey. Those who declined participation, lacked understanding of English or Mandarin, or missed the clinic appointments were excluded. Those caring for more than one patient participated only once. RESULTS Of the 195 surveys collected, 178 were used for analysis. The PPE used an average of 1.50 AEDs (range: 0-4). Forty-nine (27.5%) caregivers reported giving CAMs to their PPE. Commonly used CAMs were multivitamins (44.4%), traditional herbs (42.2%), and acupuncture (17.4%). Multivitamins were mostly given by Christian/Catholic caregivers while Buddhist caregivers mostly gave traditional herbs or acupuncture. The majority of the CAM users were Chinese. Univariate analysis showed that caregivers with secondary school (high school) education were 3.52 times more likely to use CAMs compared to those with primary school (elementary school) education. CONCLUSIONS While some caregivers gave CAMs to their PPE, they had various misconceptions and did not discuss the usage with their healthcare providers. We propose that the predictors identified in this study can help to identify potential CAM users. Healthcare providers should routinely probe about the usage of CAMs by PPE, and thereafter, the suitability of CAM use could be evaluated. The caregivers will benefit from open discussion with healthcare professionals on the safe use of AEDs with or without CAMs.
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Hall-Parkinson D, Tapper J, Melbourne-Chambers R. Parent and caregiver knowledge, beliefs, and responses to convulsive seizures in children in Kingston, Jamaica - A hospital-based survey. Epilepsy Behav 2015; 51:306-11. [PMID: 26319073 DOI: 10.1016/j.yebeh.2015.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 07/31/2015] [Accepted: 08/01/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to determine the knowledge and beliefs about seizures and actions during seizures of parents/caregivers of Jamaican children hospitalized for convulsive seizures. DESIGN AND METHODS This was a cross-sectional study of parents and caregivers of children with acute convulsive seizures hospitalized at the Bustamante Hospital, Kingston, Jamaica between May 1 and October 31, 2013. Subjects were identified by admission records. Parents/caregivers were invited to participate. A questionnaire on the demographics, knowledge, beliefs, and response of parents/caregivers during the child's current seizure episode was administered face to face. Data were analyzed for frequencies: groups were compared using chi-square analysis for categorical variables, Student's t-test for normally distributed data, and the Mann-Whitney U-test for data not normally distributed. RESULTS There were fifty participants: 39 (78%) mothers, mean (SD) age - 33.8 (10.1) years. All sought medical care first. Twenty-two (44%) had plausible beliefs about the cause of seizures. Twenty-seven (54%) knew of appropriate actions during a seizure, 10 (20%) knew of appropriate precautions, and 11 (22%) responded appropriately during the seizure. Eleven (22%) reported receiving seizure education. Witnessing a previous seizure, education level, and seizure education were associated with knowledge of seizures (p<0.05). Socioeconomic status was higher in those with plausible beliefs about seizures and lower in those who took appropriate action during a seizure (p<0.05). CONCLUSION Parents/caregivers of children with convulsive seizures have appropriate health-care seeking behavior, but most do not have appropriate knowledge about seizures. Few take appropriate action during the episode. A public education program is needed to improve parental knowledge of and response to convulsive seizures.
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Affiliation(s)
| | - Judy Tapper
- Bustamante Hospital for Children, Kingston, Jamaica
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Gyasi RM, Siaw LP, Mensah CM. Prevalence and pattern of traditional medical therapy utilisation in Kumasi Metropolis and Sekyere South District, Ghana. JOURNAL OF ETHNOPHARMACOLOGY 2015; 161:138-146. [PMID: 25523371 DOI: 10.1016/j.jep.2014.12.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 11/30/2014] [Accepted: 12/01/2014] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Whilst over three-quarters of the world׳s population continues to use traditional medicine (TRM) with an increasing trend globally, limited data exist in the Ashanti Region regarding TRM utilisation. This study espoused a retrospective cross-sectional quantitative approach to examine the prevalence and pattern of TRM use among the general population in the Kumasi Metropolis and Sekyere South District, Ghana. MATERIALS AND METHODS A sample of 324, drawn through systematic random sampling was used. The main instrument for data collection was formal face-to-face interviewer-administered questionnaire. Data were analysed using Chi-square and Fisher's exact tests from the PASW (V.17.0) with p ≤ 0.05 as significant. RESULTS The survey found that TRM use alongside conventional medicines was pervasive with prevalence of 86.1%. Biologically-based therapies (88.5%) and distant prayer interventions (58.4%) were commonly used modalities through the influence of families (50.3%), friends (19.4%) and the mass media (18.0%). Whilst self-administration and purchases from pharmacy shops remained important sources of TRM, TMPs׳ consultation was less credible (p<0.005). The disclosure rate of TRM use to health care professionals remained low (12.2%; p<0.001). CONCLUSION Concomitant TRM use with conventional therapies without disclosure may interfere with the potency of treatment regimen and result in drug interactions. Inclusion of alternative medicines on the National Health Insurance Scheme's drug plan will fortify monitoring and professional administration of TRM. Information as regards TRM use needs to be incorporated into clinical and medical practice, hence the need to prioritise patient-physician communication.
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Affiliation(s)
- Razak Mohammed Gyasi
- Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Lawrencia Pokuah Siaw
- Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Charlotte Monica Mensah
- Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
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15
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Su SY, Muo CH, Sung FC, Morisky DE. Reduction of surgery rate in endometriosis patients who take Chinese medicine: a population-based retrospective cohort study. Complement Ther Med 2014; 22:632-9. [DOI: 10.1016/j.ctim.2014.06.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 06/01/2014] [Accepted: 06/29/2014] [Indexed: 11/17/2022] Open
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16
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Chiang KL, Cheng CY. Prevalence and neuro-psychiatric comorbidities of pediatric epilepsy in Taiwan: a national population-based study. Epilepsy Res 2014; 108:1451-60. [PMID: 25107685 DOI: 10.1016/j.eplepsyres.2014.07.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 06/27/2014] [Accepted: 07/14/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Children with epilepsy may have comorbidities that result in significant disability. Epidemiological information for pediatric patients with epilepsy in Taiwan is scant. This research estimates the prevalence and common neuro-psychiatric comorbidities of children with epilepsy in Taiwan. METHODS Patients aged less than 20 years old who had received a diagnosis of epilepsy and suffered from epileptic seizures in 2005 were identified in the NHIRD based on ICD-9-CM and prescription records for the use of at least one AED. We used cases of epileptic seizure to survey outpatient service data, and identify common neuro-psychiatric comorbidities. The crude prevalence rate and the age- and sex-specific prevalence were estimated. We also examined the effects of urbanization. RESULTS The estimated prevalence of epilepsy was 0.33% in the pediatric population, with 0.29% for girls and 0.36% for boys. The most common neuropsychiatric comorbidities were learning disability and developmental delay, cerebral palsy, and mental retardation. Epilepsy was more prevalent in boys than in girls, especially among infants, preschool children, and those living in rural areas. In addition, boys with epilepsy had a higher rate of neurological comorbidities. The prevalence of psychiatric comorbidities was lower than that reported in previous studies performed in other countries, especially among children with epilepsy living in rural areas. CONCLUSION This research provides the largest nationwide, population-based study of childhood epilepsy to estimate the prevalence and the associated neuropsychiatric comorbidities of pediatric epilepsy in Taiwan. Potential rural-urban disparity basing on prevalence and associated neuropsychiatric comorbidities cannot be ignored in Taiwan.
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Affiliation(s)
- Kuo-Liang Chiang
- Department of Pediatric Neurology, Kuang-Tien General Hospital, No. 117, Shatian Road Shalu District, Taichung City 433, Taiwan ROC.
| | - Chen-Yang Cheng
- Program of Health Administration, Tunghai University, No. 181, Section 3, Taichung Harbor Road, Taichung, 407-04, Taiwan ROC.
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17
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Yeon GM, Lee YJ, Kim YM, Nam SO. Combined Use of Conventional Medicine with Traditional Korean Medicine to Treat Children with Epilepsy. J Altern Complement Med 2014; 20:461-5. [DOI: 10.1089/acm.2013.0429] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Gyu-Min Yeon
- Department of Pediatrics, College of Medicine, Kosin University, Busan, Korea
| | - Yun-Jin Lee
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Young Mi Kim
- Department of Pediatrics, Pusan National University Hospital, Busan, Korea
| | - Sang Ook Nam
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea
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Al Asmi A, Al Maniri A, Al-Farsi YM, Burke DT, Al Asfoor FMH, Al Busaidi I, Al Breiki MHA, Lahiri S, Braidy N, Essa MM, Al-Adawi S. Types and sociodemographic correlates of complementary and alternative medicine (CAM) use among people with epilepsy in Oman. Epilepsy Behav 2013; 29:361-6. [PMID: 24011398 DOI: 10.1016/j.yebeh.2013.07.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Revised: 07/18/2013] [Accepted: 07/22/2013] [Indexed: 11/25/2022]
Abstract
Nonpharmacological treatment strategies that originate from sociocultural teachings and are beyond the scope of allopathic medicine are commonly used among people with epilepsy (PWE) in many parts of the world. The present study explored the types and sociodemographic correlates of complementary and alternative medicine (CAM) use among PWE in Oman among attendees of a neurological unit at a tertiary care center. Data on the types of CAM were gathered from telephone interviews. The relevant demographic and clinical characteristics of the participants were obtained from electronic medical records. Of the total of 101 participants, 73.3% were CAM users. The majority of these participants have not disclosed their CAM use to their allopathic health-care providers. The most common types of CAM reported were those falling under the 'mind-body' type (incantations and fumigation) and biologically based (herbal concoctions) or a combination of them. Compared to non-CAM users, a significant and greater proportion of CAM users attributed the etiology of their illness to nonbiomedical factors such as 'evil eyes' (P=0.04). The multivariate logistic regression model indicated that the use of CAM was highly associated with age of <30years (OR=3.09; 95% CI: 1.10, 5.46), unemployment (OR=2.04; 95% CI: 1.15, 6.39), having basic school education (OR=2.21; 95% CI: 0.83, 5.18), low family income (OR=1.52; 95% CI: 0.91, 2.11), and the presence of hypersalivation (OR=2.20; 95% CI: 1.01, 4.39). Further studies are needed to harmonize these two healing practices. On the whole, this study indicates that among attendees of tertiary care utilization, CAM is common among PWE in Oman. The most utilized type of CAM falls under the umbrella of mind-body practice.
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Affiliation(s)
- Abdullah Al Asmi
- Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.
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Chang HYA, Wallis M, Tiralongo E, Wang HL. Decision-making related to complementary and alternative medicine use by people with Type 2 diabetes: a qualitative study. J Clin Nurs 2013; 21:3205-15. [PMID: 23083393 DOI: 10.1111/j.1365-2702.2012.04339.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To explore how complementary and alternative medicine (CAM) users make decisions about CAM use. Specifically, an exploration of the processes used by people with Type 2 diabetes, related to the assessment of information sources, factors influencing decision-making and the role of other key individuals, was undertaken. BACKGROUND Patients with chronic illnesses increasingly seek to use CAM to improve their well-being. Currently, however, the decision-making processes related to CAM use among people with Type 2 diabetes are poorly understood. METHODS An exploratory study using a naturalistic design, with in-depth semi-structured interviews, was undertaken. Purposive sampling was used to recruit participants with Type 2 diabetes who used CAM alongside conventional medicine. The data were analysed in a three-step coding process. Ethical approval was gained from a human research ethics committee. RESULTS Evidence about CAM use from interview data was consistent with a multi-dimensional decision-making processes used by participants. Four major categories emerged: recognising the need for using CAM; assessing the potential CAM before use; matching CAM use to personal philosophy; and ongoing evaluation of CAM. CONCLUSION As diabetes affects the entirety of a person's being self-management, incorporating CAMs has become a way of controlling the condition and improving well-being. It is important for health professionals to consider clients' CAM use and to incorporate this information, where appropriate, into management plans. RELEVANCE TO CLINICAL PRACTICE Health care professionals should be aware of patients who use CAM while under conventional medical care and should discuss CAM use at various points in the client journey to facilitate better communication.
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