Aims : Epilepsy is a life‐changing disease, and patients with epilepsy may face a number of issues. Paediatricians and general practitioners are often the first to be asked for advice. This cross‐sectional study was performed to gain information on the knowledge and experiences of paediatricians and general practitioners on epilepsy. Methods : From September 2015 to July 2017, paediatricians and general practitioners in Leipzig, Germany, were asked to take part in a face‐to‐face interview. Results : Overall, 40 paediatricians and 60 general practitioners participated in the study. A total of 99/100 (99%) kept emergency medication available and 96/100 (96%) would administer it during a seizure. Also, 40/40 (100%) of the paediatricians and 34/60 (57%) of the general practitioners recommended that non‐professionals should administer emergency medication, and 18/40 (45%) of the paediatricians and 35/60 (58%) of the general practitioners would put an object in the patient's mouth during a seizure. With regards to safety precautions, paediatricians mentioned the risks associated with swimming (30/40; 75%) and the potential of falling from a height (23/40; 58%), whereas general practitioners focused on being around vehicles including driving regulations (43/60; 72%). Only 5/60 (8%) of the general practitioners advised that precautions should be taken during swimming. Fatigue/exhaustion was the most common adverse drug event associated with long‐term anticonvulsive therapy mentioned by paediatricians (13/40; 33%) and general practitioners (27/60; 45%). Of all the participants, 23/100 (23%) recommended epilepsy training programmes for patients and families, however, none were able to name a specific programme. Conclusion : Nearly half of the general practitioners did not recommend the use of rescue medication by non‐professionals. This measure, however, can prevent the occurrence of prolonged non‐treatable seizures. Both paediatricians and general practitioners should bear in mind that placing an object in the mouth during a seizure should be avoided due to the risk of additional injury. To reduce the risk of drowning, physicians should recommend safety precautions during swimming. Information on epilepsy training programmes for patients and families should be diffused to all physicians taking care of patients with epilepsy.
ZusammenfassungZiel: In der Therapie chronisch rezidivierender Atemwegsinfekte wird Echinacea purpurea (Echinacin) häufig eingesetzt. Diese Studie soll zeigen, ob die Behandlung mit Echinacin bei Patienten mit einem rezidivierenden Infekt der oberen Atemwege gegenüber einer Therapie ohne Verwendung eines Immunmodulators einen höheren Nutzen im Sinne der Alltagswirksamkeit (effectiveness) bewirkt. Material und Methoden: Zur Nutzenbewertung wurden die Rezidivhäufigkeit und -dauer dokumentiert sowie der Ressourcenverbrauch und die Patientenzufriedenheit erfasst. In dieser prospektiven, nicht randomisierten, multizentrischen, bundesweiten, zweiarmigen Versorgungsforschungsstudie wurden Daten von 995 Patienten (782 Echinacin-, 213 Standard-Kohorte) mit chronisch rezidivierenden Atemwegsinfekten erhoben. Es wurden die Perspektiven der Krankenkassen, des Patienten und der Gesundheitspolitik eingenommen. Ergebnisse: Das Erkrankungsrisiko für ein Rezidiv war unter Standardtherapie durchschnittlich um das 2,3-fache (95 % KI: 1,69; 3,02) höher (p < 0,001) und die Dauer der Rezidive im Median (Hodges-Lehmann-Schätzer) um einen (95 % Moses-KI: 0; 3) Tag länger als unter Echinacin (p = 0,013). Die durchschnittlichen Gesamtkosten pro Patient betrugen innerhalb des Betrachtungszeitraums von drei Monaten in der Standard-Kohorte 238,35 E und in der Echinacin-Kohorte 228,95 E (p = 0,762). Adjustiert bezüglich der Anzahl der Symptome ergaben sich durchschnittliche Gesamtkosten für die Standard-Kohorte von 251,05 E und für die Echinacin-Kohorte 225,49 E (p = 0,409). Schlussfolgerung: Diese Versorgungsforschungsstudie hat am Beispiel der Behandlung von chronisch rezidivierenden Atemwegsinfekten mit Echinacin gezeigt, dass auch nicht verschreibungspflichtige Abstract Purpose: Echinacea purpurea (echinacin) is frequently used in the therapy of chronic recurrent respiratory disease. The aim of this study was to show whether treatment of chronic recurrent respiratory disease with Echinacin has a greater benefit in terms of effectiveness than therapy without an immunomodulator. Materials and Methods: Frequency, duration of recurrence, resources used and patients' satisfaction was documented in order to assess benefit. In this prospective, non-randomised, multicentre, nationwide, two-armed health services research study, data of 995 patients (782 echinacin-, 213 standard-cohort) with chronic recurrent respiratory disease were collected. The perspectives of statutory health insurance (SHI), patients and health policy were taken into consideration. Results: The risk of falling ill was 2.3 fold higher and the duration of relapse 1.4 days more compared to the standard-cohort. There was a clinical and economical benefit from the therapy with echinacin for SHI and health policies. In contrast, patients experienced a greater financial burden. Average total costs per patient during the observation period of 3 months amounted to 238.35 E in the standardcohort and to 228.95 E in the echinacin-cohort. Results of the intent-to-treat-analysis were recon...
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