PubMed Health⌕ Search

Biomedical subjects

Patricia G Hosking

Publications and source records attributed to Patricia G Hosking.

5 recordsLinked to original sources
PubMed2004

The specialist nurse role in the treatment of refractory epilepsy.

The main aim of epilepsy treatment is rapid and complete control of seizures without antiepileptic drug (AED) side effects. This outcome is achieved in 60-70% of newly diagnosed patients. In refractory epilepsy, new AEDs render some additional patients seizure free but make treatment more complex. The choice of AEDs, their differing pharmacokinetics, efficacy, tolerability and potential interactions are multiplied. Up to of 75% of patients develop AED side effects, most AEDs can cause paradoxical reactions, and when AED doses are changed seizures may worsen. Despite the increased complexity of epilepsy treatment and the biomedical and psychosocial consequences of uncontrolled seizures, many patients have difficulty accessing specialist services. A service that involves the epilepsy nurse specialist (ENS) giving patients and General Practitioners (GPs) free access to treatment advice has recently been established to improve care. Over a 2-week period 60 treatment-related telephone or outpatient consultations were provided out of a total of 124 contacts. Changes to the AED regimen were implemented in 44/60, and the GP was notified by letter in 31/44. The audit results are presented and epilepsy treatment including AED efficacy, tolerability, interactions and side effects are discussed.

Anticonvulsants↗
PubMed2002

The epilepsy nurse specialist at a tertiary care hospital-improving the interface between primary and tertiary care.

Recent literature suggests that access to an epilepsy nurse specialist (ENS) may help improve patients understanding and management of their condition and in doing so may decrease morbidity and mortality. This paper describes the role of the ENS at a large tertiary referral epilepsy centre, the National Hospital for Neurology and Neurosurgery (NHNN) in supporting patients with refractory epilepsy in the hospital and community. Approximately 300 patients were referred to the ENS in the first 6 months of the service. A questionnaire was posted to 193 patients, 69% responded. Most patients had multiple seizures each month, took polytherapy, underwent frequent antiepileptic drug (AED) dose changes and often experienced drug side effects. Sixty percent of patients contacted the ENS for urgent medical advice. Important aspects of the service were access by telephone to medication advice, information, support and adequate time to discuss issues. The ENS improved continuity of, and accessibility to, care for patients, has become a key member of the multidisciplinary epilepsy team and has freed up scarce medical time.

Adult↗