Document Detail


Antiepileptic drug treatment in a community health care setting in northern Ecuador: a prospective 12-month assessment.
MedLine Citation:
PMID:  8504794     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The results of a prospective assessment of antiepileptic drug treatment carried out over a 12-month period, in the context of existing community health care in a rural area of a developing country (a highland region of northern Ecuador), are reported. A house to house survey defined all patients in the area with a history of epileptic seizures, and 192 patients with active epilepsy were recruited into the programme. These patients were randomised to treatment with carbamazepine or phenobarbital, and 139 completed the assessment. Treatment was carried out by health visitors and rural doctors, monitored by a team of neurologists, and standard treatment regimens were used. Treatment was effective in controlling seizures, 53% of the patients were rendered entirely seizure free in the second 6 months of therapy, and a further 14% had a 50% or more reduction in seizures. These results were similar to those reported in hospital based studies in developed countries. No significant differences were found between the efficacy and safety of phenobarbital or carbamazepine. Antiepileptic drug levels were monitored during the study, and ranges similar to those found in developed countries were recorded. Compliance was good. In view of the successful treatment in this community control programme, we would recommend that community programmes for the control of epilepsy in rural settings should be given a higher priority in the planning of health care provision than is commonly the case. Finally, the programme afforded the opportunity to study the efficacy of treatment in patients with chronic long-standing epilepsy, who had not been previously treated, and the results of this treatment were good.
Authors:
M Placencia; J W Sander; S D Shorvon; M Roman; F Alarcon; C Bimos; S Cascante
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Epilepsy research     Volume:  14     ISSN:  0920-1211     ISO Abbreviation:  Epilepsy Res.     Publication Date:  1993 Mar 
Date Detail:
Created Date:  1993-07-08     Completed Date:  1993-07-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8703089     Medline TA:  Epilepsy Res     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  237-44     Citation Subset:  IM    
Affiliation:
Community Management of Epilepsy Project, Quito, Ecuador.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anticonvulsants / therapeutic use*
Child
Child, Preschool
Community Health Services*
Ecuador
Epilepsy / drug therapy*
Humans
Middle Aged
Prospective Studies
Time Factors
Chemical
Reg. No./Substance:
0/Anticonvulsants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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