TY - JOUR
T1 - Quality of care of epilepsy in Italy
T2 - A multi-hospital survey of diagnosis and treatment of 1104 epileptic patients
AU - Beghi, E.
AU - Sasanelli, F.
AU - Spagnoli, A.
AU - Tognoni, G.
PY - 1982
Y1 - 1982
N2 - We surveyed the treatment of 1104 patients admitted to 27 out of the 46 departments of neurology (64.5%), neurosurgery (23.0%), and child neurology (12.5%) of Lombardy, the largest Italian Region (population, 9,000,000). Our main aim was to assess the penetration of correct diagnostic and clinicopharmacological information into routine practice. A detailed analysis and discussion are given of data concerning reasons for hospital admission (therapeutic adjustment accounting for 27.3%; diagnostic ascertainment, 53.8%); characteristics of the disease, in terms of duration, clinical manifestations, and pattern of seizures; associated disorders; prevalence and criteria for the use of instrumental diagnostic procedures (EEG, brain scan, computed tomography, etc.); pattern of prescriptions of anticonvulsant drugs at admission and at discharge, with particular emphasis on specific drug choices by specialty; prevalence of single-drug therapy (41% at admission and 47.0% at discharge) versus polytherapy; degree of correspondence between recommended and observed dosage regimens (undertreatment being a more common problem than excessive dosing); and reporting of side effects. Although some of the findings of some recent studies are confirmed, this report documents the feasibility of a regular audit program of the performance of an entire health care system in the treatment of epilepsy.
AB - We surveyed the treatment of 1104 patients admitted to 27 out of the 46 departments of neurology (64.5%), neurosurgery (23.0%), and child neurology (12.5%) of Lombardy, the largest Italian Region (population, 9,000,000). Our main aim was to assess the penetration of correct diagnostic and clinicopharmacological information into routine practice. A detailed analysis and discussion are given of data concerning reasons for hospital admission (therapeutic adjustment accounting for 27.3%; diagnostic ascertainment, 53.8%); characteristics of the disease, in terms of duration, clinical manifestations, and pattern of seizures; associated disorders; prevalence and criteria for the use of instrumental diagnostic procedures (EEG, brain scan, computed tomography, etc.); pattern of prescriptions of anticonvulsant drugs at admission and at discharge, with particular emphasis on specific drug choices by specialty; prevalence of single-drug therapy (41% at admission and 47.0% at discharge) versus polytherapy; degree of correspondence between recommended and observed dosage regimens (undertreatment being a more common problem than excessive dosing); and reporting of side effects. Although some of the findings of some recent studies are confirmed, this report documents the feasibility of a regular audit program of the performance of an entire health care system in the treatment of epilepsy.
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M3 - Article
C2 - 7075569
AN - SCOPUS:0020025240
VL - 23
SP - 133
EP - 148
JO - Epilepsia
JF - Epilepsia
SN - 0013-9580
IS - 2
ER -