Chin Richard Fm, Ajetunmobi Omotomilola, Weir Christopher J, Wood Rachael
Muir Maxwell Epilepsy Centre, University of Edinburgh, Royal Hospital for Sick Children.
Muir Maxwell Epilepsy Centre, University of Edinburgh, Centre for Population Health Sciences, University of Edinburgh, Information Services Division, NHS National Services Scotland.
Epileptic Disord. 2015 Jun;17(2):172-6. doi: 10.1684/epd.2015.0745.
UK guidelines do not recommend prescribing emergency antiepileptic drugs after first simple febrile seizures or for single afebrile seizures. Non-adherence to the guidelines could result in substantial health service cost.
Scottish national hospital discharge records were used to identify children aged one month to 4 years admitted for a first febrile seizures or single afebrile seizures between April 2009 and March 2012. Prescriptions for antiepileptic drugs within 12 months of index admission were identified on the national community prescribing database by matching unique patient identifiers.
There were 1,978 and 663 children admitted for febrile seizures and single afebrile seizures, respectively. One percent of children admitted with febrile seizures and 1.7% with single afebrile seizures had a subsequent community prescription record for emergency antiepileptic drugs within 12 months of index admission. Total cost of emergency antiepileptic drugs following febrile seizures and single afebrile seizures for the study period was just over £900.
Health care providers and policy makers can be reassured that emergency antiepileptic drugs are not being inappropriately overprescribed for febrile seizures and single afebrile seizures.
英国指南不建议在首次单纯热性惊厥或单次无热惊厥后开具紧急抗癫痫药物。不遵守该指南可能会导致大量医疗服务成本。
利用苏格兰国家医院出院记录来确定2009年4月至2012年3月期间因首次热性惊厥或单次无热惊厥入院的1个月至4岁儿童。通过匹配唯一患者标识符,在国家社区处方数据库中确定索引入院后12个月内的抗癫痫药物处方。
分别有1978名和663名儿童因热性惊厥和单次无热惊厥入院。热性惊厥入院儿童中有1%,单次无热惊厥入院儿童中有1.7%在索引入院后12个月内有后续社区紧急抗癫痫药物处方记录。研究期间热性惊厥和单次无热惊厥后紧急抗癫痫药物的总成本刚刚超过900英镑。
医疗服务提供者和政策制定者可以放心,对于热性惊厥和单次无热惊厥,紧急抗癫痫药物没有被不恰当地过度开具。