Evidence-based standards of care for adults with epilepsy - a literature review

Epilepsy is the most common serious chronic neurological condition. All patients with epilepsy regardless of location should receive the highest quality of services that can be provided. In order to do this current service provision has to be reviewed and benchmarked against ideal standards of service provision that cover a comprehensive range of services to meet all patient needs. By critically reviewing the relevant literature, criteria were developed for an ideal epilepsy service. The literature review generated evidence-based ideal standards for the following service areas: The role of primary care and the interface with secondary care in the management of epilepsy; The role of Accident and Emergency (A&E) departments in the care of epilepsy; Epilepsy clinics; Specialist epilepsy nurses for treating epilepsy; The role of the general practitioner (GP) specialist; Services for adult epileptics with learning disabilities; Services for complex epilepsy; and User views. Although many of the recommendations are based on evidence of a lower grade, the direction of the existing evidence obtained from several sources, suggested similar standards for an epilepsy service. The effectiveness and value of epilepsy services, particularly in relation to the changes recommended above, must be further researched. (C) 2003 BEA Trading Ltd. Published by Elsevier Science Ltd. All rights reserved.