The Pharmaceutical Journal
Vol 268 No 7199 p705-712
25 May 2002

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Sudden epilepsy deaths avoidable

Many cases of sudden unexpected death in epilepsy are potentially avoidable and are due, in some cases, to inadequate drug management, an audit has shown.

The National Institute for Clinical Excellence commissioned the patient group Epilepsy Bereaved to produce a national audit report on epilepsy-related death. The audit suggests that 59 per cent of deaths in children could potentially or probably be avoided and that drug management is inadequate in 45 per cent of cases. Among adults, 20 per cent have inadequate drug management.

The audit showed that most adults were receiving one or two anti-epilepsy drugs but 6 per cent of adults and 18 per cent of children were not receiving any anti-epilepsy medication when they died.

The audit also considered patient review in primary care and found that it was unstructured. Most reviews by general practitioners were just to prescribe medication or check blood drug levels. In secondary care, there was little evidence to show that the management of epilepsy had been discussed with patients or their carers. Although 14 per cent of adults had a problem adhering to their drug regimens, there was little to suggest that this issue was discussed.

The findings from the audit will be considered by NICE when it develops its clinical guideline on the management of epilepsy and in its appraisal of drugs used to manage epilepsy (expected in June 2004 and September 2003, respectively).