Biomedical subjects

L Stanaway

Publications and source records attributed to L Stanaway.

5 recordsLinked to original sources

PubMed1986

Factors which influence the effectiveness of treatment of epilepsy.

Despite recent advances in the management of epilepsy, some patients continue to have seizures which defy therapeutic intervention. To examine factors which may influence the successful application of therapy a survey was carried out of 103 patients, with a previous diagnosis of epilepsy, who had a seizure for which an ambulance was called. It was evident that anticonvulsants are not always used to their maximum potential or under optimal conditions. Problems which were identified in treatment included the widespread use of polypharmacy. Patients contributed to failure of seizure control by lack of compliance with therapy (29 patients) and by excessive alcohol consumption (19 patients).

Alcohol Drinking↗

PubMed1985

Non-compliance with anticonvulsant therapy as a cause of seizures.

Compliance with anticonvulsant therapy was assessed in 95 epileptic subjects with uncontrolled seizures. Following a seizure for which an ambulance was called, patients were interviewed and questioned on their medication taking. Compliance was also determined from measurement of anticonvulsant concentrations in saliva, and from intervals between collection of drugs from pharmacy. Compliance failure was found to be instrumental in precipitating 29 (31%) of seizures for which the ambulance was called. At the time of interview, 35 (37%) subjects were not taking their medication regularly in accordance with prescribing instructions. In addition to forgetting medication, many subjects deliberately stopped or changed doses of drugs. Other causes of non-compliance which were indentified included patient misunderstanding of prescribing instructions. Compliance with therapy was positively related to perceived benefit from anticonvulsant therapy.

Adolescent↗

PubMed1983

Epilepsy and driving.

A survey was made of driving habits of 103 epileptic patients who, having suffered a seizure, were picked up by the Wellington Free Ambulance Service. It was found that 21 (20%) subjects were driving a motor vehicle--for nine this was necessary for their employment; 57% of drivers with epilepsy reported that the Ministry of Transport had not been informed of their epilepsy. For three subjects a driving accident was a direct result of their seizure. Forty-three percent of subjects in this study claimed never to have had any professional advice about driving. Of the 21 subjects who continued to drive, 13 were receiving inadequate drug therapy at the time of seizure. Advice and drug therapy for epileptic patients therefore required regular review. We consider that the Ministry of Transport should issue a simple statement about epilepsy and driving which should explain the law, risks, precipitating factors for epilepsy, and the need for good drug control. This should be issued to doctors and also be available for those applying for a driving licence.

Accidents, Traffic↗

PubMed1981

Prescribing patterns for epilepsy.

All prescriptions for anticonvulsants written over a four month period for patients in the Wellington area were identified. Of 1479 patients receiving anticonvulsants, 139 were suspected of receiving medication for conditions other than epilepsy. The prevalence of treated epilepsy in Wellington is 4.1 per 1000 population. Thirty-eight percent of patients were on multiple anticonvulsants, which compares favourably with reports of excessive polypharmacy in Europe. However, there was excessive reliance on standard anticonvulsant doses, given at frequent intervals regardless of probable rates of metabolism. Failure of compliance, as assessed by the time intervals between collection of drugs, was shown by 21 percent of patients.

Adult↗

PubMed1979

Assessment of the cost/effectiveness of chemotherapy for skin and urinary tract infections using in vitro sensitivity testing.

Results of skin and urine cultures performed by a Wellington laboratory over a selected period, were used to estimate the prevalence of common organisms and their in vitro sensitivity to chemotherapeutic agents, to determine the most efficacious and economical, anti-infective therapy. For streptococcal or mixed gram positive infections penicillin is the antibiotic of choice. For mild to moderate staphylococcal infections, erythromycin is indicated. A single dose of cotrimoxazole is economical for uncomplicated urinary tract infections, however urine culture seems warranted. Reservations are expressed regarding the assessment of in vitro sensitivity to cotrimoxazole and possible development of resistance to this agent. Ampicillin/amoxycillin is indicated for organisms resistant to sulphonamides. The need to supply doctors with information on changing sensitivity patterns of micro-organisms in the community is emphasised.

Anti-Bacterial Agents↗