Management and Attitudes of Epilepsy by a Group of Sydney General Practitioners

Abstract

Previous surveys of general practitioners (GPs) have shown stereotypic attitudes and management of persons with epilepsy (PWE). We mailed a questionnaire to 107 GPs in the Sydney and Illawarra regions of Australia to evaluate changes in knowledge and management of epilepsy and attitudes of GPs toward PWE as compared with results of a similar study made 10 years previously. Most GPs referred patients with epilepsy to a neurologist for initial management in preference to initiating investigation and treatment themselves. GPs were very satisfied with their sharing of care with neurologists, but indicated their high level of dissatisfaction with other health care therapists because of impractical advice and lack of empathy. The GPs' objectives of continuing management were mainly to prevent seizures, monitor of medication and its effects, and reduce the impact of patients' epilepsy on their daily life. Although many GPs believed that PWE were more likely to have emotional and relationship problems, most also believed that such persons contribute equally to society and can have normal quality of life (QOL). Although the GPs prefer to use a neurologist for initial management of PWE, they see themselves as having a role in continuing care and providing psychosocial support. The stereotyped perceptions of GPs indicated in the previous study have improved, although in some respects they remain negative. This study offers an audit of the outcome of a decade of educational promotion regarding epilepsy.

Doctor's perspectives and practices regarding epilepsy

“…Rutgers,6 concluded that the GP were prone to this role, but only about half of our doctors accept to follow up the care initially proposed by the specialist. As emphasized by Frith et al 5 , GP in general have an important role in the prevention of new seizures, minimization of AED side effects, and maintaining the patients self-esteem contributing to the life quality maintenance, Neuro 03.p65 01/06/00, 13:22 225 that can reduce the impact of patient's epilepsy on their daily life. Consequently, there is a need to set it to undergraduate medical curricula, and programs of continuing medical education, better information for diagnosis and treatment approach, psychosocial issues about people living with epilepsy, avoiding misconceptions about these patients and consequently barriers (perceived or not) in their medical, social and psychological care.…”

“…Consequently, researches have been carried out taking community and medical students' attitudes into account, as it was already done in Brazil 1 , as well as medical knowledge and practices [2][3][4][5][6][7] . The medical care emphasizes all the dimensions of the human being, psychosocial and biological.…”

“…They are usually the person's primary care providers who has recently experienced a first seizure. In this way, it is especially important to know their professional practices and attitudes regarding PWE, apart from the neurologists, as it was done by the Australian group leaded by Roy G. Beran 3,5 . Danesi 4 , did this in a developing country.…”

Psychosocial Aspects of Epilepsy in Oman: Attitude of Health Personnel

“…Caveness and Gallup's (17) longitudinal studies and others (10,12) have shown increased awareness and social acceptance of epilepsy, but negative attitudes still persist in many countries (8,10). Surprisingly, many of the stereotyped attitudes about epilepsy that have been identified in the general community also were found in the medical profession (18–22). Medical education has been reevaluated in light of the prevailing attitude in some developed countries (23,24).…”

Initial Perspectives from Midwestern Neurologists: Epilepsy Patients' Barriers and Motivators for Seeking Treatment

“…In order to close this gap and help providers better understand how to address barriers to epilepsy treatment, provider opinions on epilepsy must be assessed. Previous studies compared perceptions of patients and care providers (DiIorio and Manteuffel, 1995; Choi‐Kwon et al, 2001; Aldenkamp and Van Donselaar, 2003), assessed knowledge and attitudes of general practitioners (Frith et al, 1994; Averis, 1997; Thapar et al, 1998; Thapar and Roland, 2005), and compared different physician attitudes (including general practitioners and neurologists) (Vogtle et al, 2007). In general, such studies find a need for improved education and destigmatization even among health professionals, a finding confirmed by American epilepsy patient perceptions (Paschal et al, 2005).…”