Demonstration project on epilepsy in Brazil: outcome assessment

Abstract

-Purpose: To assess the outcome of patients with epilepsy treated at primary care health units under the framework of the demonstration project on epilepsy in Brazil, part of the WHO/ILAE/IBE Global Campaign Against Epilepsy. Method: We assessed the outcome of patients treated at four primary health units. The staff of the health units underwent information training in epilepsy. The outcome assessment was based on: 1) reduction of seizure fre q u e n c y, 2) subjective perception from the patient's and the physic i a n 's point of view, 3) reduction of absenteeism, 4) social integration (school and work), and 5) sense of independence. Results: A total of 181 patients (93 women -51%) with a mean age of 38 (range from 2 to 86) years were studied. The mean follow-up was 26 months (range from 1 to 38 months, 11 patients had follow-up of less than 12 months). Seizure frequency was assessed based on a score system, ranging f rom 0 (no seizure in the previous 24 months) to 7 (>10 seizure/day). The baseline median seizure -f re q u e ncy score was 3 (one to three seizures per month). At the end of the study the median seizure -f re q u e n c y score was 1 (one to three seizures per year). The patients' and relatives' opinions were that in the majority (59%) the health status had improved a lot, some (19%) had improved a little, 20% experienced no change and in 2% the health status was worse. With regard to absenteeism, social integration and sense of independence, there were some modest improvements only. Discussion: The development of a model of epilepsy treatment at primary health level based on the existing health system, with strategic measu res centred on the health care providers and the community, has proved to be effective providing important reductions in seizure fre q u e n c y, as well as in general well being. This model can be applied nationwide, as the key elements already exist provided that strategic measures are put forw a rd in accord a n c e with local health providers and managers.KEY WORDS: epilepsy, anti-epileptic drug, seizure, primary care.Projeto demonstrativo em epilepsia no Brasil: avaliação do desfecho RESUMO -Objetivo: Avaliar o resultado do tratamento de pacientes com epilepsia na atenção básica sob o modelo proposto pelo Projeto Demonstrativo no Brasil, como parte da Campanha Global Contra a Epilepsia da WHO/ILAE/IBE. Método: Avaliamos o resultado do tratamento nos pacientes acompanhados em quat ro unidades básicas de saúde. As equipes de saúde fizeram um treinamento padrão. O resultado do tratamento foi baseado em cinco aspectos: 1) redução da freqüência das crises, 2) percepção subjetiva dos pacientes e dos médicos, 3) redução de absenteísmo, 4) integração social (escola, trabalho), e 5) senso de independência. Resultados: Um total de 181 pacientes (93 mulheres -51%), com uma média de 38 anos (variando de 2 a 86 anos) entraram nesta análise. O tempo médio de seguimento foi de 26 meses (variou de 1 a 38 meses, 11 pacientes tinham seguimento menos de 12 meses). A freqüência das cr...

Training medical students to improve the management of people with epilepsy

“…I n s t rument -The KAP Questionnaire ( K n o w l e d g e , Attitude and Perception) of the Global Campaign "Epilepsy out of the Shadows", from WHO, ILAE and IBE 6 . This quest i o n n a i re evaluates knowledge, attitude and perc e p t i o n s with 61 closed questions.…”

“…To imp rove this situation, we suggest that better education of health professionals can be instituted, especially at the undergraduate level of medicine. This study, part of phase II of the National Demonstration Project on Epilepsy in Brazil, part of the WHO/ILAE/IBE Global Campaign Against Epilepsy, executed by ASPE, Assistência à Saúde de Pacientes com Epilepsia 6 , aims to evaluate the knowledge, attitude and perceptions of medical students prior to and after an epilepsy training course.…”

Training the trainers and disseminating information: a strategy to educate health professionals on epilepsy

“…The phase II of the Demonstration Project on Epilepsy part of the Global Campaign Epilepsy Out of the Shadows-WHO-ILAE-IBE in Brazil, executed by ASPE, Assistência à Saúde de Pacientes com Epilepsia 9 , focused on educational interventions to impro v e knowledge, attitudes and perceptions of health professionals and school teachers. Here we describe the development of diff e rent modules of educational int e rvention and their results when applied to primary care health professionals.…”

Stigma scale of epilepsy: validation process

“…Stud i e s 1 7 -2 0 p o rtray stigma in somewhat diff e rent perspectives, and the results are derived from qualitative assessments. We wish to highlight the import a nce of the study of stigma of epilepsy, emphasizing that a specific quantitative instrument for its evaluation should be created 16 .…”

“…This is phase III of the Demonstration Project on Epilepsy in Brazil, part of WHO/ILAE/IBE Global Campaing Against Epilepsy, executed by ASPE, Assistência à Saúde de Pacientes com Epilepsia 16 .…”